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Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study


Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim (2015). Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study. BMJ Open, 5(4):e007443.

Abstract

Objectives: To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland.
Design: Longitudinal study with three points of measurement.
Setting: Primary care practices in Switzerland.
Participants: In total, 45 of 91 primary care practices completed European Practice Assessment three times.
Outcomes: The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time.
Results: Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01).
Conclusions: The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.

Abstract

Objectives: To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland.
Design: Longitudinal study with three points of measurement.
Setting: Primary care practices in Switzerland.
Participants: In total, 45 of 91 primary care practices completed European Practice Assessment three times.
Outcomes: The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time.
Results: Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01).
Conclusions: The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:01 Jul 2015 14:32
Last Modified:14 Aug 2017 20:07
Publisher:BMJ Publishing Group
ISSN:2044-6055
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1136/bmjopen-2014-007443
PubMed ID:25900466

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