Quality in primary care
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Quality in primary care · Jan 2010
An international perspective on the basis for payment for performance.
This discussion paper reflects on the pay-for-performance system in UK general practice - the Quality and Outcomes Framework (QOF) - from an international viewpoint. The QOF intends to bring the best scientific evidence to bear on primary care practice. However, the QOF and patient-centred medicine are often at odds. ⋯ The extent of impact of the QOF on health outcomes and on equity of health outcomes needs examination. Attention to resolution of patients' problems is an important aim of quality improvement activities. Alternative modes of improving patient care may be better than the QOF.
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Quality in primary care · Jan 2009
Learning from four years of collaborative access work in Australia.
Through the three years of the first phase of the Australian Primary Care Collaborative there was considerable adaptation of the work to improve access translated from the UK to the Australian environment. Changes in four areas are described. ⋯ Four possible changes are offered for consideration to those planning to do access work with general practices based on the learning from the Australian Primary Care Collaborative.
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Patient-centred consulting is at the heart of modern medicine, and training programmes now routinely highlight a range of communication skills that enhance the doctor-patient relationship. The present pilot study focuses on the central role played by empathic skills in developing rapport and shared understanding, as captured in a new model developed by the authors. The specific aim of the study was to evaluate the potential of a short-term training programme using this model to improve rapport-related behaviour in general practitioner (GP) trainees. ⋯ The significant improvement in rapport-related knowledge, attitudes and behaviour after training, and the lack of any comparable change in the control group, gives some support to the suggestion that the module (and the model that underpinned it) may have triggered such an impact independent of ongoing experience or other educational activities.