Document Detail


Continuous quality improvement in small general medical practices: the attitudes of general practitioners and other practice staff.
MedLine Citation:
PMID:  11669567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Continuous quality improvement (CQI) offers opportunities to improve care in small-scale office-based practice. Little is yet known about the implementation of CQI in small primary care practices. We studied the attitudes of physicians and staff in small family practices to a model of CQI tailored to office-based practice setting. PRACTICES AND DESIGN: An exploratory study in 20 family practices in The Netherlands. Practices were stimulated to adopt the model for continuous quality improvement. MAIN OUTCOME MEASURES: The use of the model at the end of the study period, the perception of the physicians and staff of their success with adopting the model, their view of its usefulness, their willingness to continue and personal and practical obstacles. Measurements were made using written questionnaires. RESULTS: The rate of implementation of the model varied between practices. Participants rated their success in performing improvement projects, holding regular quality meetings and setting targets and priorities. They were positive about the usefulness of the model and they were generally willing to continue to use it. Barriers included the size of workload and the tendency to postpone actions until external support by an outreach visitor was provided. Physician and staff attitudes were homogeneous at a practice level. CONCLUSION: Our findings stress the importance of starting CQI with small, easy-to-handle projects. Workload reduction might be an important issue to focus on. Personal obstacles should be addressed throughout the introduction. We found attitudes in small-scale practices to be homogeneous, so that it was important to pay explicit attention to commitment to CQI from the start of the introduction.
Authors:
H Geboers; H Mokkink; P van Montfort; H van den Hoogen; W van den Bosch; R Grol
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua     Volume:  13     ISSN:  1353-4505     ISO Abbreviation:  Int J Qual Health Care     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-23     Completed Date:  2002-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9434628     Medline TA:  Int J Qual Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  391-7     Citation Subset:  IM    
Affiliation:
Center for Quality of Care Research (WOK), Department of General Medicine, University of Nijmegen, The Netherlands. hgeboers@knmg.nl
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel*
Family Practice / standards*
Guideline Adherence
Health Services Research
Models, Organizational*
Netherlands
Physician Assistants / psychology
Physicians, Family / psychology
Practice Management, Medical / standards
Questionnaires
Total Quality Management / organization & administration*,  utilization
Workload

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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