Document Detail

The effects of a team-based continuous quality improvement intervention on the management of primary care: a randomised controlled trial.
MedLine Citation:
PMID:  17007709     Owner:  NLM     Status:  MEDLINE    
AIM: To study the effects of a team-based model for continuous quality improvement (CQI) on primary care practice management.
DESIGN OF STUDY: Randomised controlled trial.
SETTING: Twenty-six intervention and 23 control primary care practices in the Netherlands.
METHOD: Practices interested in taking part in the CQI project were, after assessment of their practice organisation, randomly assigned to the intervention or control groups. During a total of five meetings, a facilitator helped the teams in the intervention group select suitable topics for quality improvement and follow a structured approach to achieve improvement objectives. Checklists completed by an outreach visitor, questionnaires for the GPs, staff and patients were used to assemble data on the number and quality of improvement activities undertaken and on practice management prior to the start of the intervention and 1 year later.
RESULTS: Pre-test and post-test data were compared for the 26 intervention and 23 control practices. A significant intervention effect was found for the number of improvement objectives actually defined (93 versus 54, P<0.001) and successfully completed (80 versus 69% of the projects, P<0.001). The intervention group also improved on more aspects of practice management, as measured by our practice visit method, than the control group but none of these differences proved statistically significant.
CONCLUSION: The intervention exerted a significant effect on the number and quality of improvement projects undertaken and self-defined objectives met. Failure of the effects of the intervention on the other dimensions of practice management to achieve significance may be due to the topics selected for some of the improvement projects being only partly covered by the assessment instrument.
Yvonne Engels; Pieter van den Hombergh; Henk Mokkink; Henk van den Hoogen; Wil van den Bosch; Richard Grol
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  56     ISSN:  0960-1643     ISO Abbreviation:  Br J Gen Pract     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-29     Completed Date:  2007-04-23     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  781-7     Citation Subset:  IM    
Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, KWAZO 229, 6500 HB Nijmegen, Netherlands.
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MeSH Terms
Family Practice* / organization & administration,  standards
Patient Care Team* / organization & administration,  standards
Quality Indicators, Health Care
Quality of Health Care* / organization & administration,  standards

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