• Christos Lionis, Mariza Tsiraki, Vassilios Bardis, and Anastasios Philalithis.
• Department of Social and Family Medicine, Crete University School of Medicine, Heraklion, Crete, Greece. lionis@galinos.med.uoc.gr
• Croat. Med. J. 2004 Oct 1; 45 (5): 599-603.

AimTo implement quality improvement programs and assess the clinical effectiveness within the primary care setting.MethodsThe introduction of clinical governance teams, the establishment of a patient-based record system, and the dissemination of practice guidelines were included among the efforts made to improve the quality of care. The clinical effectiveness was measured using EUROPEP (European Task Force on Patient Evaluations of General Practice tool) for evaluating patient's opinion and contracts between health authorities and primary care physicians and nurses.ResultsClinical governance teams of 5-6 practitioners were formed in all health centers. Health cards were created for 6,150 individuals, and a high satisfaction rate with the interest in the patient's personal situation (97.6% of participants assessed it as excellent), physical examination (97.6%), and giving information about symptoms and illness (97.6%) was recorded on the EUROPEP sample. Lack of infrastructure and diagnostic equipment were considered as important barriers in implementing contracts in primary care.ConclusionPrimary health care in a rural setting in Crete is engaged in setting up systems for implementing clinical governance and quality programs. The Regional Authorities of Health and Welfare should provide further support.

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