Quality in primary care
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In recent years there have been concerns regarding the prescribing of antipsychotic drugs to patients with dementia in nursing homes, due to adverse effects, inappropriate indications and insufficient review. Our practice decided to look at this difficult area more closely. ⋯ The introduction of the checklist and six-monthly review led to an improvement in the recording of a clear indication for the antipsychotic drug and of documented review. As a practice we were pleased with the modest reduction in the prescribing of antipsychotic drugs in nursing home patients. We were satisfied that the patients who remain on these drugs are being reviewed appropriately and that the benefit of prescribing outweighs the risk.
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Quality in primary care · Jan 2009
Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.
The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. ⋯ Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.