Quality in primary care
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Quality in primary care · Jan 2011
Building high functioning clinical teams through quality improvement initiatives.
Team-based care has consistently been associated with improved clinical outcomes. However, strategies for promoting and sustaining a team-based approach in family medicine practice are more elusive. ⋯ These findings suggest a strategic role for clinical performance feedback linked to team initiated quality improvement initiatives for improving both clinical outcomes and clinical team-based care.
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Quality in primary care · Jan 2011
Pilot study to develop and test a generic peer feedback instrument to review videotaped consultations in primary care.
The ability to consult effectively is key to the delivery of quality patient care. External peer review of consultations has been available to general medical practitioners (GPs) in the west of Scotland for several years. Pharmacists are expected to provide increasingly complex advice for patients. This study describes the development and first steps in the evaluation of a generic tool to be used to inform feedback about both GP and pharmacist consultations with patients. ⋯ The results suggest that the instrument is useful only when applied to practitioners who have been taught how to consult in a patientcentred manner, and have led to the introduction of training in consultation skills for pharmacists throughout Scotland. Potential reliability in providing peer feedback for GP consultations is important in the context of the provision of consistent, meaningful evidence for GP appraisal and revalidation in the UK.
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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.