Quality in primary care
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Quality in primary care · Jan 2011
Reducing variation in general practitioner referral rates through clinical engagement and peer review of referrals: a service improvement project.
General practitioner (GP) referral rates to hospital services vary widely, without clearly identified explanatory factors, introducing important quality and patient safety issues. Referrals are rising everywhere year on year; some of these may be more appropriately redirected to lower technology services. ⋯ This intervention appeared acceptable to GPs because of its emphasis on reviewing appropriateness and quality of referrals and was effective and sustainable while the investment in resources continued. Consultant involvement in discussions appeared important. The intervention's cost-effectiveness requires evaluation for consideration of future referral management strategies.
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Quality in primary care · Jan 2011
Design of a quality and performance improvement project for small primary care practices: reflections on the Center for Practice Innovation.
Small practices often lack the human, financial and technical resources to make necessary practice improvements and infrastructure investments in order to achieve sustainable change that promotes quality and efficiency. ⋯ Small practices today are facing a range of important challenges. The CPI sought to provide successful guidance to small practices with evidence of positive change in some clinical measures, patient satisfaction and practice motivation to implement quality of care and practice management improvements.
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All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would benefit from the contribution of health services research (HSR) on a wide range of topics. As funding for such research is limited, priorities need to be defined. ⋯ Given funding constraints, it is imperative that research priorities are identified to ensure that resources are devoted to the most pressing and important issues facing primary care. Priority areas for future research are amongst others the evaluation of primary care reforms in Europe, and the relations between primary and secondary care.
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Quality in primary care · Jan 2011
Developing quality indicators for community services: the case of district nursing.
Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. ⋯ Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.
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Quality in primary care · Jan 2011
Does a general practitioner support unit reduce admissions following medical referrals from general practitioners?
Emergency medical admissions to UK hospitals have been increasing steadily over the past few decades and there are likely to be a proportion of these admissions that are avoidable. This evaluation aims to demonstrate whether a general practitioner support unit (GPSU) reduces general practitioner (GP) referred emergency medical admissions to an acute hospital. ⋯ An acute GP led service run from within the hospital to provide support to community GPs led to a modest reduction in the number of GP admissions to the MAU, but did not reduce the number of GP admissions to the hospital wards.