Can clinical governance deliver quality improvement in Australian general practice and primary care? A systematic review of the evidence

2010 ◽  
Vol 193 (10) ◽  
pp. 602-607 ◽  
Author(s):  
Christine B Phillips ◽  
Christopher M Pearce ◽  
Sally Hall ◽  
Joanne Travaglia ◽  
Simon Lusignan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Clinical Governance ◽  
Australian General Practice

scholarly journals Quality and general practice accreditation: The approach of Australian General Practice Accreditation Limited

1999 ◽  
Vol 22 (4) ◽  
pp. 161 ◽  
Author(s):  
Rob Pegram ◽  
David Wright
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Continuous Quality ◽  
Australian General Practice

The purpose of this article is to outline the underlying assumptions, principles and processes of a continuous quality improvement approach which underpins the accreditation of general practice offered by Australian General Practice Accreditation Limited.

Assessing the uptake and effectiveness of a quick reference guide to antibiotic prescribing in Australian general practice

2016 ◽  
Vol 22 (6) ◽  
pp. 565 ◽  
Author(s):  
Angus Thompson ◽  
Patrick O'Sullivan ◽  
Elisabeth Banham ◽  
Greg Peterson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Antimicrobial Stewardship ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Reference Guide ◽  
Treatment Dose ◽  
Dosing Frequency ◽  
Australian General Practice ◽  
Prescribing Practice

Prescribing guidelines are an essential component of antimicrobial stewardship programs in Australian hospitals. Nonetheless, the majority of antibiotic prescribing occurs in the community and the effectiveness of guidelines developed specifically to meet the needs of Australian general practice is unknown. This study aims to assess the uptake and effectiveness of a quick reference guide to antibiotic prescribing among primary care prescribers. A quick reference guide to antibiotic prescribing was developed and prescribers in five Tasmanian practices were surveyed regarding use of this guide. Thirty-three surveys were returned and, of those answering specific sections, 75% were aware of the guide and 71% had used it within the last month. The guide affected the antibiotic prescribing practice of 74% of responding prescribers; most often on choice of antibiotic; but also on duration of treatment, dose and dosing frequency. A quick reference guide to antibiotic prescribing was well received by prescribers and may usefully support efforts to improve antimicrobial stewardship in the community.

scholarly journals Learning from the Implementation of a Quality Improvement Intervention in Australian General Practice: A Qualitative Analysis of a CVD Preventive Care Project

2021 ◽  
Author(s):  
Charlotte Hespe ◽  
Edwina Brown ◽  
Lucie Rychetnik
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
Health System ◽  
Financial Incentives ◽  
Clinical Care ◽  
Quality Improvement Intervention ◽  
Successful Implementation ◽  
Full Potential ◽  
Australian General Practice ◽  
General Practices

Abstract BackgroundQuality-improvement collaborative (QIC) initiatives aim to reduce gaps in clinical care provided in the healthcare system. This study provides a qualitative evaluation of a QIC project (QPulse) in Australian general practice focused on improving cardiovascular disease (CVD) assessment and management. MethodsThis qualitative-methods study explored implementing a QIC project by a Primary Health Network (PHN) in 34 general practices. Qualitative analyses examined in-depth interviews with participants and stakeholders focusing on barriers and enablers to implementation in our health system. They were analysed thematically using the Complex Systems Improvement framework (CSI), focusing on strategy, culture, structure, workforce, and technology.ResultsDespite strategic engagement with QPulse objectives across the health system, implementation barriers associated with this program were considerable for both PHN and the general practices. Adoption of the QIC process was reliant on engaged leadership, practice culture, systems for clear communication, tailored education and regular clinical audit and review. Practice ownership, culture and governance, rather than practice size and location, were related to successful implementation. Financial incentives for both the PHN and general practice were identified as prerequisites for systematised quality improvement (QI) projects in the future, along with individualised support and education provided to each practice. Technology was both an enabler and a barrier, and the PHN was seen as key to assisting the successful adoption of the available tools. ConclusionsImplementation of QI programs remains a potential tool for achieving better health outcomes in General Practice. However, enablers such as individualised education and support provided via a meso-level organisation, financial incentives, and IT tools and support are crucial if the full potential of QI programs are to be realised in the Australian healthcare setting. Trial registrationACTRN12615000108516, UTN U1111-1163-7995.

scholarly journals Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
George A Samoutis ◽  
Elpidoforos S Soteriades ◽  
Henri E Stoffers ◽  
Theodora Zachariadou ◽  
Anastasios Philalithis ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Quality Improvement Intervention ◽  
Improvement Intervention

The practice manager role and relevance to general practice-based research: a review of the literature

2016 ◽  
Vol 22 (2) ◽  
pp. 86 ◽  
Author(s):  
Anna Wood ◽  
Jane Hocking ◽  
Meredith Temple-Smith
Keyword(s):  
Systematic Review ◽  
General Practice ◽  
Future Research ◽  
Review Of The Literature ◽  
Manager Role ◽  
Practice Based Research ◽  
Australian General Practice ◽  
Communication And Coordination ◽  
Evidenced Based

Research based in Australian general practice is essential to ensure that health care provided in this setting is evidenced-based and delivered effectively. Research designed for general practice must be feasible and acceptable to general practitioners (GPs) and practice managers (PMs), who are responsible for coordinating practice activities. However, little is known about the PM role and their contribution to research undertaken in general practice. The aim of this systematic review is to examine this role and its relevance to the conduct of general practice-based research. Databases searched (Medline, PubMed, CINAHL and Scopus) identified six relevant studies. One study investigated the role of the PM in general practice-based research and five examined aspects of the PM role. Data about study design, number and type of participants and findings was extracted and managed using a matrix framework. The limited findings suggested PMs are interested in managing research at the practice level. The PM is central to practice communication and coordination but the role varies depending on qualifications, size of practice and expectations of the GPs. This paper highlights the paucity of evidence about the PM role and their contribution to the conduct of research undertaken in general practice. Further investigation is required to gain insights into establishing and managing future research in Australian general practice.

scholarly journals Inequalities in general practice remote consultations: A systematic review

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0040
Author(s):  
Ruth Parker ◽  
Emma Figures ◽  
Charlotte Paddison ◽  
James Matheson ◽  
David Blane ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
General Practice ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
The Elderly ◽  
Face To Face ◽  
The Impact ◽  
Remote Consultations

BackgroundCOVID-19 has led to rapid and widespread use of remote consultations in general practice, but the health inequalities impact remains unknown.AimTo explore the impact of remote consultations in general practice compared to face-to-face consultations on utilisation and clinical outcomes across socio-economic and disadvantaged groups.Design & settingSystematic reviewMethodWe undertook an electronic search of MEDLINE, EMBASE and Web of Science from inception to June 2020. We included studies which compared remote consultations to face-to-face consultations in primary care and reported outcomes by PROGRESS Plus criteria. Risk of bias was assessed using ROBINS-I. Data was synthesised narratively.ResultsBased on 13 studies, exploring telephone and internet-based consultations, we found that telephone consultations were used by younger working age people, the very old and non-immigrants, with internet-based consultations more likely to be used by younger people. Women consistently used more remote forms of consulting than men. Socio-economic and ethnicity findings were mixed, with weak evidence that patients from more affluent areas were more likely to use internet-based communication. Remote consultations appeared to help patients with opioid dependence remain engaged with primary care. No studies reported on the impact on quality of care or clinical outcomes.ConclusionRemote consultations in general practice are likely to be used more by younger working people, non-immigrants, the elderly and women, with internet-based consultations more by younger, affluent and educated groups. Wide-spread use of remote consultations should be treated with caution until the inequalities impact on clinical outcomes and quality of care is known.

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