Programme no. 140-OP
What makes General Practitioners participate in modern quality-improvement projects in Denmark?
Pia Therkildsen*1, Henrik Prinds Rasmussen2, Eva Rudjord Therkildsen3, Anders Munck4, Jesper Lykkegaard5
1Møllegade Lægehus,Sønderborg,Denmark;Audit Project Odense, Research Unit of General Practice,University of Southern Denmark,DK 5000 Odense,Denmark, 2Audit Project Odense, Research Unit of General Practice,University of Southern Denmark,DK 5000 Odense,Denmark, 3University of Southern Denmark,DK 5000 Odense,Denmark, 4Audit Project Odense, Research Unit of General Practice,University of Southern Denmark,DK 5000 Odense,Denmark, 5Audit Project Odense, Research Unit of General Practice,University of Southern Denmark,DK 5000 Odense,Denmark
* = Presenting author
Objectives: The aim of this study was to investigate GPs’ attitude towards a specific quality- improvement initiative carried out by Audit Project Odense (APO) targeted at introducing a new national Danish guideline on the treatment of elderly patients in general practice.
Background: Different actions have been performed in order to improve implementation of new evidence in general practice. However, knowledge about GPs’ attitude towards quality development is sparse.
Results: Telephone interviews were made with six GPs, six nurses, and one secretary. The informants generally agreed that a simple set-up, an individualised approach, and a local anchoring were important reasons for participating in the project. The APO brand, the modern computerised approach, and the interdisciplinary participation were important factors too. Most practices reported that they had gained new information and some that they had changed procedures and/or improved their in-clinic cooperation in the treatment of elderly patients as result of their participation in the audit.
Material/Methods: GPs voluntarily signed on for a 3-months audit. For each patient, above the age of 74 years a computer-based pop-up questionnaire with 10 items regarding health- and social issues was filled in. Questionnaire data were automatically supplemented by data from the patients’ electronic health records. Half way through the audit period the GPs and staff met for a seminar on elderly people. At the seminar and after the audit clinic-specific quality-reports on elderly patients’ health, social conditions, and treatment were handed out to the participating practices. Three months after the registration period, a structured telephone interview with a GP or member of staff in each of 21 participating practices was conducted. Open and closed questions were asked regarding the participants’ opinion about the audit.
Conclusion: The participant evaluation worked well and obtained information valuable to the planning of future audits.
Points for discussion: How to obtain a systematic participant evaluation of
quality-improving projects in general practice? How do we learn from the participants?
How to obtain ownership of learning culture and improvement projects?
How to ensure appropriate coordination of learning initiatives?