Comprehensive assessment of the quality of care in small-scale primary care practices

  • Geboers H
  • Mokkink H
  • Van Montfort P
 et al. 
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Abstract

Introduction: In primary care methods are needed that help make an inventory of the quality of organisation and performance with respect to running practice audits adequately, participating in a clinical governance programme and making district plans for improvement. This paper concerns our experience with a comprehensive assessment of primary care practices. It also reflects on the possibility of identifying subjects and practices that qualify for improvement, and whether practices actually started improvement activities on the identified areas. Design: A comprehensive assessment was performed on a predefined set of 27 quality indicators, including medical performance, practice organisation, equipment for home visits, accessibility of data, collaboration and quality activities and patient satisfaction. Practices: 39 Dutch primary care practices. Main outcome measures: The number of indicator scores we were able to compute with the data collected, the variation of indicator scores between practices and the number of improvement projects started on one or more of the indicators assessed. Results: The assessment was performed in all practices. The number of indicator scores that could be computed varied from 21 to 27 per practice. In 27 practices (69%) all indicators could be computed. Subjects that were identified as qualifying for improvement included performance on chronic disorders, data management, practice hygiene and patient accomodation. Practices that needed to improve could be identified. Practices selected subjects that qualified for improvement, but also hobbies and topics outside the set of indicators. Discussion: It was possible to collect the data necessary to compute the majority of scores on the indicators selected. On the whole, the set of indicators was fairly complete, but it lacked some issues with regard to practice management. It provided relevant information for practices and district leaders to establish priorities and make district plans for improvement.

Author-supplied keywords

  • Comprehensive assessment
  • Netherlands
  • Organisation
  • Performance
  • Primary care
  • Quality indicator
  • article
  • chronic disease
  • data analysis
  • evaluation
  • health care access
  • health care delivery
  • health care management
  • health care planning
  • health care quality
  • health service
  • human
  • hygiene
  • medical audit
  • medical information
  • medical practice
  • patient care
  • patient satisfaction
  • primary medical care
  • scoring system

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Authors

  • H Geboers

  • H Mokkink

  • P Van Montfort

  • H Van Den Hoogen

  • W Van Den Bosch

  • R Grol

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