• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of qualhcLink to Publisher's site
Qual Health Care. Sep 1999; 8(3): 161–166.
PMCID: PMC2483655

Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non-physician observers

Abstract

Objective - To evaluate and compare the effects of two programmes of assessment of practice management in a practice visit: mutual visits and feedback by peers compared with visits and feedback by non- physician observers. Design - Prospective, randomised intervention study, with follow up after one year. Setting - General practices in the Netherlands in 1993 and 1994. Subjects - A total of 90 general practitioners (GPs) in 68 practices; follow up after one year comprised 81 GPs in 62 practices. Main measures - Scores on indicators and dimensions of practice management in the visit instrument to assess practice management and organisation (a validated Dutch method to assess practice management in a practice visit). Change was defined as the difference in score between the first visit and the visit after one year on 208 indicators and on 33 dimensions of practice management. Results - Data of 44 mutual visits by peers were compared with data of 46 visits by non-physician observers. After a year both programmes showed improvements on many aspects of practice management, but different aspects changed in each of the two programmes. After mutual practice visits, GPs scored significantly higher on content of the doctor's bag, on collaboration with colleagues, on collaboration with other care providers, and on accessibility of patient information than after a visit by a non-physician observer. The visits by non-physician observers resulted in a higher score on extent of use of records and on assessment on outcome and year report. Conclusion - Change after mutual practice visits and feedback by peers is more marked than after a visit and feedback by a non-physician observer.

Full Text

The Full Text of this article is available as a PDF (97K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Grol R. Quality improvement by peer review in primary care: a practical guide. Qual Health Care. 1994 Sep;3(3):147–152. [PMC free article] [PubMed]
  • Wensing M, van der Weijden T, Grol R. Implementing guidelines and innovations in general practice: which interventions are effective? Br J Gen Pract. 1998 Feb;48(427):991–997. [PMC free article] [PubMed]
  • Petchey R. Collings report on general practice in England in 1950: unrecognised, pioneering piece of British social research? BMJ. 1995 Jul 1;311(6996):40–42. [PMC free article] [PubMed]
  • Steele MA, Bess DT, Franse VL, Graber SE. Cost effectiveness of two interventions for reducing outpatient prescribing costs. DICP. 1989 Jun;23(6):497–500. [PubMed]
  • Eliasson G, Berg L, Carlsson P, Lindström K, Bengtsson C. Facilitating quality improvement in primary health care by practice visiting. Qual Health Care. 1998 Mar;7(1):48–54. [PMC free article] [PubMed]
  • Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med. 1989 Jan 5;320(1):53–56. [PubMed]
  • Mugford M, Banfield P, O'Hanlon M. Effects of feedback of information on clinical practice: a review. BMJ. 1991 Aug 17;303(6799):398–402. [PMC free article] [PubMed]
  • Horder J, Bosanquet N, Stocking B. Ways of influencing the behaviour of general practitioners. J R Coll Gen Pract. 1986 Nov;36(292):517–521. [PMC free article] [PubMed]
  • Szczepura A, Wilmot J, Davies C, Fletcher J. Effectiveness and cost of different strategies for information feedback in general practice. Br J Gen Pract. 1994 Jan;44(378):19–24. [PMC free article] [PubMed]
  • Essex B, Bate J. Audit in general practice by a receptionist: a feasibility study. BMJ. 1991 Mar 9;302(6776):573–576. [PMC free article] [PubMed]
  • van den Hombergh P, Grol R, van den Hoogen HJ, van den Bosch WJ. Assessment of management in general practice: validation of a practice visit method. Br J Gen Pract. 1998 Nov;48(436):1743–1750. [PMC free article] [PubMed]
  • Groenewegen PP, Hutten JB. Workload and job satisfaction among general practitioners: a review of the literature. Soc Sci Med. 1991;32(10):1111–1119. [PubMed]
  • Ram P, Grol R, van den Hombergh P, Rethans JJ, van der Vleuten C, Aretz K. Structure and process: the relationship between practice management and actual clinical performance in general practice. Fam Pract. 1998 Aug;15(4):354–362. [PubMed]
  • Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: a literature review. Int J Qual Health Care. 1994 Jun;6(2):115–132. [PubMed]
  • Scrivens E. Policy issues in accreditation. Int J Qual Health Care. 1998 Feb;10(1):1–5. [PubMed]

Articles from Quality in Health Care : QHC are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...