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.
RCT Entities:
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.
Authors: J M Grimshaw; L Shirran; R Thomas; G Mowatt; C Fraser; L Bero; R Grilli; E Harvey; A Oxman; M A O'Brien Journal: Med Care Date: 2001-08 Impact factor: 2.983
Authors: R Grol; M Wensing; J Mainz; P Ferreira; H Hearnshaw; P Hjortdahl; F Olesen; M Ribacke; T Spenser; J Szécsényi Journal: Fam Pract Date: 1999-02 Impact factor: 2.267
Authors: S M Shortell; J L O'Brien; J M Carman; R W Foster; E F Hughes; H Boerstler; E J O'Connor Journal: Health Serv Res Date: 1995-06 Impact factor: 3.402
Authors: Helen E Lester; Tina Eriksson; Rob Dijkstra; Katrin Martinson; Tomasz Tomasik; Nigel Sparrow Journal: Br J Gen Pract Date: 2012-05 Impact factor: 5.386
Authors: Lindsay A Ballengee; Sharron Rushton; Allison A Lewinski; Soohyun Hwang; Leah L Zullig; Katharine A Ball Ricks; Katherine Ramos; Mulugu V Brahmajothi; Thomasena S Moore; Dan V Blalock; Sarah Cantrell; Andrzej S Kosinski; Adelaide Gordon; Belinda Ear; John W Williams; Jennifer M Gierisch; Karen M Goldstein Journal: J Gen Intern Med Date: 2022-01-03 Impact factor: 5.128
Authors: Rutger E Sonneveld; Michel Wensing; Ewald M Bronkhorst; Gert-Jan Truin; Wolter G Brands Journal: BMC Health Serv Res Date: 2011-10-11 Impact factor: 2.655
Authors: Sarah M Burnett; Martin K Mbonye; Sarah Naikoba; Stella Zawedde-Muyanja; Stephen N Kinoti; Allan Ronald; Timothy Rubashembusya; Kelly S Willis; Robert Colebunders; Yukari C Manabe; Marcia R Weaver Journal: PLoS One Date: 2015-09-09 Impact factor: 3.240
Authors: Pieter van den Hombergh; Beat Künzi; Glyn Elwyn; Jan van Doremalen; Reinier Akkermans; Richard Grol; Michel Wensing Journal: BMC Health Serv Res Date: 2009-07-15 Impact factor: 2.655
Authors: Jyoti Kotecha; Han Han; Michael Green; Grant Russell; Mary I Martin; Richard Birtwhistle Journal: BMC Fam Pract Date: 2015-07-30 Impact factor: 2.497