Teaching about quality improvement in specialist training for family medicine in Slovenia

Abstract

Introduction. Quality is a part of curricula in medical schools worldwide. It has a special position in family medicine, because it follows specific rules that are adapted to this discipline. Because of its specificities, teaching quality is even more important to become a part of specialist training curricula. Objective. Our aim was to describe quality improvement in family medicine specialist training curriculum in Slovenia and its practical implications and experiences. Methods. The paper describes the family medicine specialist training curriculum also including the topic on the ways quality improvement. Assignments and research protocols are used to enhance the usage of quality methods in everyday practice. An example of such a research protocol, developed by one of the trainees, is used to illustrate the process. Trainees? evaluations of the quality improvement curriculum are analyzed. Results. In the quality improvement project, 199 patients with arterial hypertension younger than 80 years were included. At the first measurement only 21 patients (10.6%) had their blood pressure within the recommended level. Six months after the quality improvement intervention 77 patients (38.9%) had controlled their blood pressure, a statistically significant improvement (p<0.001). Conclusion. Teaching quality in family medicine must be a generic part of specialist training curriculum. The use of specific assignments can underpin the necessity to use methods that follow the principles of modern education. The result of teaching process can be even measured in actual improvement in the quality of care.Uvod. Kvalitet je deo nastavnog programa medicinskih fakulteta u citavom svetu. On zauzima posebno mesto u porodicnoj medicini, jer prati specificna pravila prihvacena u okviru ove discipline. S obzirom na svoje osobenosti, jos je znacajnije da kvalitet nastave postane deo nastavnog programa specijalizacije iz ove oblasti. Cilj rada. Cilj rada je bio da se opise unapredjenje kvaliteta nastavnog programa specijalizacije porodicne medicine u Sloveniji, te ukaze na njene prakticne implikacije i stecena iskustva. Metode rada. U radu se opisuje nastavni program specijalizacije porodicne medicine koji takodje obuhvata temu o nacinima poboljsanja kvaliteta. Koriste se nastavni zadaci i istrazivacki protokoli da bi se u svakodnevnoj praksi podstakla primena kvalitetnih metoda. Navodi se primer jednog takvog istrazivackog protokola koji je sacinio jedan specijalizant, kako bi se ilustrovao sam proces njegove izrade. Analizira se procena specijalizanata nastavnog programa o unapredjenju kvaliteta. Rezultati. Projekat o unapredjenju kvaliteta obuhvatio je 199 osoba obolelih od arterijske hipertenzije koji su bili mladji od 80 godina. Pri prvom merenju samo 21 ispitanik (10,8%) je imao krvni pritisak u okviru preporucenih vrednosti. Nakon unapredjenja kvaliteta, kod 77 ispitanika (38,9%) krvni pritisak je bio u okviru preporucenih vrednosti, sto je bio statisticki znacajan napredak (p<0,001). Zakljucak. Kvalitetna nastava iz porodicne medicine mora da bude sastavni deo specijalistickog nastavnog programa kojim ce se utemeljiti potreba primene metoda koje prate principe savremenog obrazovanja. Rezultati nastavnog procesa mogu, stavise, da se mere na osnovu postignutog unapredjenja kvaliteta zdravstvene nege.