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BMJ Open. 2015 Apr 21;5(4):e007443. doi: 10.1136/bmjopen-2014-007443.

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

Author information

1
Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany.
2
EQUAM-Stiftung, Bern, Switzerland.
3
mediX Gruppenpraxis, Zürich, Switzerland.
4
Institute of General Practice and Health Services Research, University of Zürich, Zürich, Switzerland.
5
AQUA-Institute for Applied Quality Improvement and Research in Health Care, Göttingen, Germany.
6
Swisspep Institut für Qualität und Forschung im Gesundheitswesen, Bern, Switzerland.
7
Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany AQUA-Institute for Applied Quality Improvement and Research in Health Care, Göttingen, Germany.

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.

PMID:
25900466
PMCID:
PMC4410115
DOI:
10.1136/bmjopen-2014-007443
[Indexed for MEDLINE]
Free PMC Article

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