Quality in primary care
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Quality in primary care · Jan 2013
Are patients' preferences for shifting services from medical specialists to general practitioners related to the type of medical intervention?
To improve the feasibility of shifting medical specialist to general practitioner (GP) services in patient-centred health care systems, it is important to know how this substitution is valued by patients. However, insight into patients' preferences is lacking. ⋯ This study provides strong indications that patients' preferences for substitution are influenced by the type of medical intervention. Therefore it seems important that health policy makers, purchasers and practitioners take the preferences of (potential) patients into account.
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Quality in primary care · Jan 2013
Improving the management of obesity in adults: a pilot of a method to identify important barriers to change and tailor interventions to address them.
A tailored approach to implementation can facilitate the routine use of best evidence, and so improve the quality of care delivered. Tailored implementation involves investigating the context and barriers to change before selecting appropriate interventions. However, there is little evidence on the methods of tailoring. This study investigated the tailoring undertaken by two implementation groups as part of a study to improve adherence to NICE guidelines on adult obesity in primary care. ⋯ The facilitated implementation groups method succeeded in identifying appropriate and similar barriers, enablers and implementation interventions, which suggests some justification for this approach to tailoring. However, further research into methods of tailoring is required. Improvements to the implementation group approach may be realised by careful selection of group members and provision of sufficient preparation time prior to group discussions.
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Quality in primary care · Jan 2013
Back pain management in primary care: development and validity of the Patients' and Doctors' Expectations Questionnaire.
Back pain is a common disorder, with the doctor being the first point of contact for help. Biopsychosocial management of back pain has been shown to be problematic. Meeting patients' expectations is alleged to play a vital role in concordance, adherence and satisfaction. A more potent aspect, however, could be a state of matched patient- doctor expectations with regard to the consultation process and outcome, but this aspect has not been fully investigated and there is currently no valid and specific measure of this dimension. ⋯ The newly designed questionnaire showed good face, content and construct validity as well as good internal consistency, and thus can be used as a valid and reliable measure for back pain-specific expectations of the process and outcome of the consultation in primary care settings.
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This is the fourth in a series of articles about the science of quality improvement. We examine what to measure, how to measure and some important measurement techniques, such as run charts, control charts and funnel plots. These help us to understand healthcare processes, to assess whether they are stable or improving and to determine how they can be improved further.
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This is the third in a series of articles about the science of quality improvement. Leadership and management are required for change and are therefore important for all quality improvement initiatives. We describe the differences between and features of each, and how they support change in individuals, groups and organisations according to the culture and characteristics of the latter. Finally, we see that leadership competencies are conceptualised in the NHS Leadership Framework and how this can be applied to quality improvement in general practice and healthcare more generally.