Use of quality improvement methods in Finnish health centres in 1998 and 2003.

OBJECTIVE: To evaluate how widely quality improvement methods are used in Finnish primary health centres and how the use has changed over five years.
DESIGN: Two national cross-sectional postal enquiries. SETTING AND
SUBJECTS: The questionnaire in 1998 was sent to every other physician graduated during the years 1977-1986, and the questionnaire in 2003 to every other physician graduated during the years 1982-1991. The response rates were 73.9% and 62.2%. The answers of primary healthcare physicians (n = 503 vs. 344) were analysed. MAIN OUTCOME MEASURES: The availability of 13 quality improvement methods was solicited. The change over five years was analysed.
RESULTS: Opportunity to obtain continuing medical education (CME), in-service training, meetings, opportunity to consult a colleague in own speciality, and agreed guidelines on how a certain problem should be solved were highly reported both in 1998 and 2003. The biggest improvement (16.8%) concerned clinical guidelines. There was also progress with regard to quality improvement manuals at the place of work, opportunity to consult a colleague in another speciality, and computer-assisted monitoring of own work.
CONCLUSION: Many quality improvement methods were highly reported in both 1998 and 2003 in Finnish health centres. The biggest positive change concerns clinical guidelines.