Quality in primary care
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This paper considers the role of teaching primary care trusts (tPCTs) at the turn of the century. A retrospective evaluation of a complex intervention is used. The evaluation has three perspectives. These are (1) a commentary on tPCTs in health policy in England, (2) the authors' reflections as senior members of a tPCT in Northern England and (3) a look-back exercise with tPCT members. ⋯ Quality criteria for acceptability, accessibility, appropriateness, equity, clinical effectiveness and cost-effectiveness can only be truly addressed by a learning organisation approach. This was one of the original remits for tPCTs.
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Quality in primary care · Jan 2012
Multicenter StudyComprehensive assessment of chronic pain management in primary care: a first phase of a quality improvement initiative at a multisite Community Health Center.
The objective of this study was to conduct a comprehensive formative assessment of chronic pain management in a large, multisite community health centre and use the results to design a quality improvement initiative based on an evidence-based practice model developed by the Veterans Health Administration. Improving quality and safety by incorporating evidence-based practices (EBP) is challenging, particularly in busy clinical practices such as Federally Qualified Health Centers (FQHCs). FQHCs grapple with financial constraints, lack of resources and complex patient populations. ⋯ Improving chronic pain management at this Community Health Center requires a multifaceted intervention aimed at addressing many of the problems identified during the assessment phase. During the intervention we will put a greater emphasis on increasing options for behavioural health and complementary medicine support, increasing access to specialty consultation, providing pain-specific CME for providers, and improving documentation of pain care in the electronic health records.
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Quality in primary care · Jan 2012
Is a patient's type of substance dependence (alcohol, drug or both) associated with the quality of primary care they receive?
Primary care clinicians' attitudes may differ based on patients' substance dependence type (alcohol, other drugs or both). ⋯ Drug dependence was associated with worse PCQ for most domains. Understanding the reasons for these differences and addressing them may help improve the quality of primary care for patients with addictions.