The Experts below are selected from a list of 162 Experts worldwide ranked by ideXlab platform
Adrian Rohrbasser - One of the best experts on this subject based on the ideXlab platform.
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use of Quality Circles for primary care providers in 24 european countries an online survey of european society for Quality and safety in family practice delegates
Scandinavian Journal of Primary Health Care, 2019Co-Authors: Adrian Rohrbasser, Ulrik Bak Kirk, Eva ArvidssonAbstract:Objective: To identify and describe the core characteristics and the spread of Quality Circles in primary healthcare in European countries. Design: An online survey was conducted among European Society for Quality and Safety in Family Practice (EQuiP) delegates. To allow comparison with earlier results, a similar survey as in a study from 2000 was used. Setting: Primary Health Care in European countries. Subjects: General practitioners, delegated experts of the European Society for Quality and Safety in Family Practice (EQuiP). Main outcome measures: (1) Attendance in Quality Circles (2) their objectives (3) methods of Quality improvement Quality Circles use (4) facilitator's role and training (5) role of institutions (6) supporting material and data sources Quality Circles use. Results: 76% of the delegates responded, representing 24 of 25 countries. In 13 countries, more than 10% of general practitioners participated in Quality Circles, compared with eight countries in 2000. The focus of Quality Circles moved from continuous medical education to Quality improvement. Currently, Quality Circles groups use case-based discussions, educational materials and local opinion leaders in addition to audit and feedback. Some national institutions provide training for facilitators and data support for Quality circle groups. Conclusion: The use of Quality Circles has increased in European countries with a shift in focus from continuous medical education to Quality improvement. Well-trained facilitators are important, as is the use of varying didactic methods and Quality improvement tools. Qualitative inquiry is necessary to examine why QCs thrive or fail in different countries and systems. KEY POINTS Countries with already established Quality circle movements increased their participation rate and extended their range of Quality circle activities The focus of Quality Circles has moved from CME/CPD to Quality improvement Well-trained facilitators are important, as is the use of varying didactic methods and Quality improvement tools Institutions should provide supporting material and training for facilitators.
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Quality Circles for Quality improvement in primary health care their origins spread effectiveness and lacunae a scoping review
PLOS ONE, 2018Co-Authors: Adrian Rohrbasser, Janet Harris, Sharon Mickan, Kali Tal, Geoff WongAbstract:Quality Circles or peer review groups, and similar structured small groups of 6-12 health care professionals meet regularly across Europe to reflect on and improve their standard practice. There is debate over their effectiveness in primary health care, especially over their potential to change practitioners' behaviour. Despite their popularity, we could not identify broad surveys of the literature on Quality Circles in a primary care context. Our scoping review was intended to identify possible definitions of Quality Circles, their origins, and reported effectiveness in primary health care, and to identify gaps in our knowledge. We searched appropriate databases and included any relevant paper on Quality Circles published until December 2017. We then compared information we found in the articles to that we found in books and on websites. Our search returned 7824 citations, from which we identified 82 background papers and 58 papers about Quality Circles. We found that they originated in manufacturing industry and that many countries adopted them for primary health care to continuously improve medical education, professional development, and Quality of care. Quality Circles are not standardized and their techniques are complex. We identified 19 papers that described individual studies, one paper that summarized 3 studies, and 1 systematic review that suggested that Quality Circles can effectively change behaviour, though effect sizes varied, depending on topic and context. Studies also suggested participation may affirm self-esteem and increase professional confidence. Because reports of the effect of Quality Circles on behaviour are variable, we recommend theory-driven research approaches to analyse and improve the effectiveness of this complex intervention.
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Quality Circles for Quality improvement in primary health care their effectiveness gaps of knowledge origins and significance a scoping review
bioRxiv, 2018Co-Authors: Adrian Rohrbasser, Janet Harris, Sharon Mickan, Geoff WongAbstract:Abstract Background Quality Circles, or similarly structured small groups in primary health care, such as peer review groups, consist of 6 to 12 professionals from the same background who meet regularly to improve their standard practice. This paper reports the results from a scoping search performed to clarify possible effectiveness, knowledge gaps, underlying concepts and significance. Objectives To gain insight into knowledge gaps and understanding of the effectiveness, origins and significance of Quality Circles. Methods A search strategy was developed starting with ‘Quality circle’ in PubMed and the index terms from those articles revealed were then used as search terms to identify further papers. Repeating this process in collaboration with a librarian, search strings relating to Quality Circles were built, and databases searched up to December 2017. Any paper on structured Quality Circles or related small group work in primary health care was included when relevant to the objectives. Results From 11973 citations, 82 background papers and 58 key papers were identified, in addition to 12 books and 10 websites. 19 studies, one paper summarizing three studies and one systematic review suggest that Quality Circles can be effective in behaviour change, though with varying effect sizes. Quality Circles and their techniques are complex, as they are not standardized, and changes seem to depend on the topic and context, which requires further research into how and why they work in order to improve them. From their origins in industry, they are now used in primary health care in many countries for continuous medical education, continuous professional development and Quality improvement. Conclusion The evidence on Quality Circles indicates that they can successfully change general practitioner behaviour. As they are a complex intervention, theory-driven research approaches are needed to understand and improve their effectiveness. This is of major importance because they play an important role in Quality improvement in primary health care in many countries.
Geoff Wong - One of the best experts on this subject based on the ideXlab platform.
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Quality Circles for Quality improvement in primary health care their origins spread effectiveness and lacunae a scoping review
PLOS ONE, 2018Co-Authors: Adrian Rohrbasser, Janet Harris, Sharon Mickan, Kali Tal, Geoff WongAbstract:Quality Circles or peer review groups, and similar structured small groups of 6-12 health care professionals meet regularly across Europe to reflect on and improve their standard practice. There is debate over their effectiveness in primary health care, especially over their potential to change practitioners' behaviour. Despite their popularity, we could not identify broad surveys of the literature on Quality Circles in a primary care context. Our scoping review was intended to identify possible definitions of Quality Circles, their origins, and reported effectiveness in primary health care, and to identify gaps in our knowledge. We searched appropriate databases and included any relevant paper on Quality Circles published until December 2017. We then compared information we found in the articles to that we found in books and on websites. Our search returned 7824 citations, from which we identified 82 background papers and 58 papers about Quality Circles. We found that they originated in manufacturing industry and that many countries adopted them for primary health care to continuously improve medical education, professional development, and Quality of care. Quality Circles are not standardized and their techniques are complex. We identified 19 papers that described individual studies, one paper that summarized 3 studies, and 1 systematic review that suggested that Quality Circles can effectively change behaviour, though effect sizes varied, depending on topic and context. Studies also suggested participation may affirm self-esteem and increase professional confidence. Because reports of the effect of Quality Circles on behaviour are variable, we recommend theory-driven research approaches to analyse and improve the effectiveness of this complex intervention.
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Quality Circles for Quality improvement in primary health care their effectiveness gaps of knowledge origins and significance a scoping review
bioRxiv, 2018Co-Authors: Adrian Rohrbasser, Janet Harris, Sharon Mickan, Geoff WongAbstract:Abstract Background Quality Circles, or similarly structured small groups in primary health care, such as peer review groups, consist of 6 to 12 professionals from the same background who meet regularly to improve their standard practice. This paper reports the results from a scoping search performed to clarify possible effectiveness, knowledge gaps, underlying concepts and significance. Objectives To gain insight into knowledge gaps and understanding of the effectiveness, origins and significance of Quality Circles. Methods A search strategy was developed starting with ‘Quality circle’ in PubMed and the index terms from those articles revealed were then used as search terms to identify further papers. Repeating this process in collaboration with a librarian, search strings relating to Quality Circles were built, and databases searched up to December 2017. Any paper on structured Quality Circles or related small group work in primary health care was included when relevant to the objectives. Results From 11973 citations, 82 background papers and 58 key papers were identified, in addition to 12 books and 10 websites. 19 studies, one paper summarizing three studies and one systematic review suggest that Quality Circles can be effective in behaviour change, though with varying effect sizes. Quality Circles and their techniques are complex, as they are not standardized, and changes seem to depend on the topic and context, which requires further research into how and why they work in order to improve them. From their origins in industry, they are now used in primary health care in many countries for continuous medical education, continuous professional development and Quality improvement. Conclusion The evidence on Quality Circles indicates that they can successfully change general practitioner behaviour. As they are a complex intervention, theory-driven research approaches are needed to understand and improve their effectiveness. This is of major importance because they play an important role in Quality improvement in primary health care in many countries.
Joachim Szecsenyi - One of the best experts on this subject based on the ideXlab platform.
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Acceptance of dental care guidelines by Quality Circles
Zeitschrift fur Evidenz Fortbildung und Qualitat im Gesundheitswesen, 2009Co-Authors: Barbara Bergmann-krauss, Wolfgang Micheelis, Joachim SzecsenyiAbstract:The discussion about the advantages of evidence-based guidelines in daily dental practice is a matter of current interest. In this report three high-Quality S3 level pilot guidelines which have been developed in dental medicine were evaluated under practice conditions. Quality Circles in the city of Hamburg readily accepted to join this survey. By means of a questionnaire before and after a 4-month field test in dental practices the participants of Quality Circles were interviewed about their attitude towards guidelines and to the application of the guidelines. In addition, the experience gained with the application of the guidelines was incorporated into a group discussion with moderators of Quality Circles. The inclusion of quantitative and qualitative methods enabled a recording of the complete range of differentiated opinions concerning the application of guidelines. The results show that the concerns expressed by participants can be reduced by integrating guidelines in their everyday clinical practice. A strength and weakness analysis demonstrates that the Quality circle moderators' attitudes towards approved guidelines range from rather positive to ambivalent. Field testing by Quality Circles proves to be a sound method for evaluating the acceptance of guidelines in daily practice.
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Quality Circles to improve prescribing of primary care physicians three comparative studies
Pharmacoepidemiology and Drug Safety, 2009Co-Authors: Michel Wensing, Bjorn Broge, Petra Kaufmannkolle, Burgi Riens, Reinier Akkermans, Richard Grol, Joachim SzecsenyiAbstract:Purpose To determine the effectiveness of Quality Circles on prescribing patterns of primary care physicians in Germany and to explore the influence of specific factors on changes. Methods Three large non-randomised comparative studies were performed in primary care in Germany, with baseline measurements in 2001 and follow-up measurements in 2003. 1090 physicians were in intervention groups and 2090 physicians in control groups. For each physician, data on 444 patients and 1201 prescriptions were available, on average, at each measurement moment. Quality Circles comprising of a series of small group moderated meetings of physicians, provision of evidence-based information and repeated written feedback on individual prescribing patterns. Results Compared to the control groups, physicians in the intervention groups reduced mean prescription cost per patient per 3-month period by 1.87 € (95%CI 0.51 to 3.22), increased generic drugs of all potentially generic prescriptions by 0.75% (95%CI 0.40 to 1.10), increased prescription of recommended lipid lowering drugs by 4.24% (95%CI 2.40 to 6.10), increased the prescription of recommended antibiotics by 1.72% (95%CI 0.33 to 3.10). Groups with more positive views of performance feedback, evidence-based indicators and price comparisons showed more change of prescribing. Conclusions Quality Circles had a modest effect on prescribing Quality and costs. If widely implemented, they could have nationwide impact on the Quality and costs of prescribing in primary care. Copyright © 2009 John Wiley & Sons, Ltd.
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Quality Circles to improve prescribing patterns in primary medical care what is their actual impact
Journal of Evaluation in Clinical Practice, 2004Co-Authors: Michel Wensing, Bjorn Broge, Petra Kaufmannkolle, Edith Andres, Joachim SzecsenyiAbstract:Rationale, aims and objectives Quality Circles comprise small group sessions of doctors and written feedback on their individual practice patterns. Although 50% of German primary care doctors participate in Quality Circles, their effectiveness has hardly been evaluated in Germany. This study determined the impact of a large-scale programme of Quality Circles on Quality and costs of prescribing. Method A controlled before‐after study was performed, in which primary care doctors were allocated to a Quality Circles group or a control group. Subjects were 100 000 patients in 1996 and in 1998, who had visited one of 177 doctors in the 3 month registration periods in one region in Germany. The intervention comprised a Quality Circles programme, comprising 11 sessions and repeated feedback on prescribing. Main outcome measures were proportion of patients who received a prescription, mean prescription costs per patient and proportion of generic prescriptions. Results The absolute numbers of prescriptions decreased in both groups, but the mean prescription costs per patient increased. The Quality Circles reduced the proportion of patients who received a prescription (OR = 0.86) and the mean prescription costs per patient (B = - 3.99 euro), while it increased the proportion of generic drugs (OR = 1.10). The intervention had intended effects on four of the 15 secondary indicators. Conclusions Large-scale application of Quality Circles had intended effects on prescribing decisions in primary care in Germany. The effects found in this study may reflect better what improvements can be achieved than randomized trials of similar interventions.
Françoise Chevalier - One of the best experts on this subject based on the ideXlab platform.
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From Quality Circles to Total Quality
International Journal of Quality & Reliability Management, 1991Co-Authors: Françoise ChevalierAbstract:Quality Circles are a sign of the times, and their success provokes legitimate irritation for those confronted with their development. They often spark off controversy and generate subjective points of view that denote a downright unwillingness to regard them fairly. What is the bottom line? Should Quality Circles be discontinued? Are they a means of zeroing in on total Quality and, if so, how can the Circles become fully integrated and contribute to instituting total Quality? These issues are examined.
Michel Wensing - One of the best experts on this subject based on the ideXlab platform.
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Quality Circles to improve prescribing of primary care physicians three comparative studies
Pharmacoepidemiology and Drug Safety, 2009Co-Authors: Michel Wensing, Bjorn Broge, Petra Kaufmannkolle, Burgi Riens, Reinier Akkermans, Richard Grol, Joachim SzecsenyiAbstract:Purpose To determine the effectiveness of Quality Circles on prescribing patterns of primary care physicians in Germany and to explore the influence of specific factors on changes. Methods Three large non-randomised comparative studies were performed in primary care in Germany, with baseline measurements in 2001 and follow-up measurements in 2003. 1090 physicians were in intervention groups and 2090 physicians in control groups. For each physician, data on 444 patients and 1201 prescriptions were available, on average, at each measurement moment. Quality Circles comprising of a series of small group moderated meetings of physicians, provision of evidence-based information and repeated written feedback on individual prescribing patterns. Results Compared to the control groups, physicians in the intervention groups reduced mean prescription cost per patient per 3-month period by 1.87 € (95%CI 0.51 to 3.22), increased generic drugs of all potentially generic prescriptions by 0.75% (95%CI 0.40 to 1.10), increased prescription of recommended lipid lowering drugs by 4.24% (95%CI 2.40 to 6.10), increased the prescription of recommended antibiotics by 1.72% (95%CI 0.33 to 3.10). Groups with more positive views of performance feedback, evidence-based indicators and price comparisons showed more change of prescribing. Conclusions Quality Circles had a modest effect on prescribing Quality and costs. If widely implemented, they could have nationwide impact on the Quality and costs of prescribing in primary care. Copyright © 2009 John Wiley & Sons, Ltd.
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Quality Circles to improve prescribing patterns in primary medical care what is their actual impact
Journal of Evaluation in Clinical Practice, 2004Co-Authors: Michel Wensing, Bjorn Broge, Petra Kaufmannkolle, Edith Andres, Joachim SzecsenyiAbstract:Rationale, aims and objectives Quality Circles comprise small group sessions of doctors and written feedback on their individual practice patterns. Although 50% of German primary care doctors participate in Quality Circles, their effectiveness has hardly been evaluated in Germany. This study determined the impact of a large-scale programme of Quality Circles on Quality and costs of prescribing. Method A controlled before‐after study was performed, in which primary care doctors were allocated to a Quality Circles group or a control group. Subjects were 100 000 patients in 1996 and in 1998, who had visited one of 177 doctors in the 3 month registration periods in one region in Germany. The intervention comprised a Quality Circles programme, comprising 11 sessions and repeated feedback on prescribing. Main outcome measures were proportion of patients who received a prescription, mean prescription costs per patient and proportion of generic prescriptions. Results The absolute numbers of prescriptions decreased in both groups, but the mean prescription costs per patient increased. The Quality Circles reduced the proportion of patients who received a prescription (OR = 0.86) and the mean prescription costs per patient (B = - 3.99 euro), while it increased the proportion of generic drugs (OR = 1.10). The intervention had intended effects on four of the 15 secondary indicators. Conclusions Large-scale application of Quality Circles had intended effects on prescribing decisions in primary care in Germany. The effects found in this study may reflect better what improvements can be achieved than randomized trials of similar interventions.
