PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 15465939

RCGP Quality Team Development programme: an illuminative evaluation.

F Macfarlane·T Greenhalgh·T Schofield·T Desombre
View original source ↗Export metadata ↓

Abstract

BACKGROUND: There is increasing interest in quality initiatives that are locally owned and delivered, team based, multiprofessional, and formative. The Royal College of General Practitioners' Quality Team Development (QTD) programme is one such initiative aimed at developing primary healthcare teams and their services. AIMS: To evaluate QTD from the perspective of participants and assessors. SETTING: UK primary health care. DESIGN AND METHOD: Twelve of 14 practices and all four primary care organisations (PCOs) approached agreed to participate. Thirty four semi-structured interviews were conducted with key stakeholders. The interviews were taped, transcribed, and analysed using the constant comparative method. RESULTS: The QTD programme appears to be highly valued by participating organisations. Practice based respondents perceived it as acceptable and feasible, and reported positive changes in teamwork and patient services. They valued its formative, participative, and multiprofessional nature, especially the peer review element. PCOs saw QTD as a method of delivering on prevailing national policies on clinical quality and modernization agendas as well as promoting interorganizational collaboration. The main concerns raised were the workload, particularly for assessors, and maintaining the quality of the assessments and the programme. CONCLUSION: This qualitative study suggests positive benefits for participants in the QTD programme. However, such practices are a self-selecting innovative minority. Further research is needed on more typical practices to identify barriers to their participation in QTD or other formative, team based quality improvement programmes.

Explore related subjects

Attitude of Health PersonnelBenchmarkingCooperative BehaviorEnglandFamily PracticeHumansInterviews as TopicManagement Quality CirclesPatient Care TeamPrimary Health CareProgram DevelopmentQualitative ResearchRural Health ServicesSocieties, MedicalTotal Quality ManagementUrban Health ServicesWalesEvaluation StudyJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

F Macfarlane, T Greenhalgh, T Schofield, T Desombre. 2004. RCGP Quality Team Development programme: an illuminative evaluation.. https://doi.org/10.1136/qhc.13.5.356

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Using enquiry in learning: from vision to reality in higher education.

This paper reports on the contribution of six nurse educators to embed enquiry-led learning in a pre-registration nursing programme. Their focus was to evaluate student and facilitator perspectives of a hybrid model of problem-based learning, a form of enquiry-based learning and to focus on facilitators' perceptions of its longer-term utility with large student groups. Problem-based learning is an established learning strategy in healthcare internationally; however, insufficient evidence of its effectiveness with large groups of pre-registration students exists. Fourth Generation Evaluation was used, applying the Nominal Group Technique and Focus Group interviews, for data collection. In total, four groups representing different branches of pre-registration students (n = 121) and 15 facilitators participated. Students identified seven strengths and six areas for development related to problem-based learning. Equally, analysis of facilitators' discussions revealed several themes related to strengths and challenges. The consensus was that using enquiry aided the development of independent learning and encouraged deeper exploration of nursing and allied subject material. However, problems and frustrations were identified in relation to large numbers of groups, group dynamics, room and library resources and personal development. The implications of these findings for longer-term utility with large student groups are discussed.

Attitude of Health Personnel↗
PubMed2006

Physician-stakeholder collaboration in Disability Management: a Canadian perspective on guidelines and expectations.

PURPOSE: The physician plays a vital role in Disability Management; unfortunately, there is an apparent lack of clarity with respect to the functions included in this role. The present article reviews the collaborative nature of the physician-stakeholder relationship giving attention to types of expectations, current Canadian guidelines and future challenges. CONCLUSION: The authors conclude that although challenging and complex, the physician's performance in Disability Management can be optimized through improved communication and collaboration with stakeholders.

Attitude of Health Personnel↗
PubMed2006

Physicians' perceived knowledge of and responsibility for managing patients' out-of-pocket costs for prescription drugs.

BACKGROUND: Most insurers in the US have implemented incentive-based formularies that rely on out-of-pocket costs to influence prescription drug utilization. Medicare Part D plans have broadly adopted such benefit designs. OBJECTIVE: To evaluate physicians' perceptions of their knowledge of formularies and out-of-pocket costs, factors that influence knowledge of costs, physicians' perceived responsibility for helping patients manage their out-of-pocket costs for prescription drugs, and physicians' perceptions of the role of pharmacists in managing these costs. METHODS: A multiple-choice survey was mailed to a random sample of 1200 physician members of the California Medical Association; a phone survey of nonresponders was then conducted. RESULTS: Of 1027 surveys delivered to correct addresses, 509 (49.6%) responses were received. Thirty-three percent of physicians reported that they were usually or always aware of patients' formularies and 20% were usually or always aware of patients' out-of-pocket costs for medications. Surgeons, emergency department physicians, and physicians that prescribe from more formularies than other physicians are less likely to be aware of patients' out-of-pocket costs, while physicians in large practices and those who use computers to prescribe are more aware. While 91% of physicians agreed that it is important that patients' out-of-pocket costs be managed, 40% somewhat or strongly agreed that it is their responsibility to help. Sixty-five percent of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. CONCLUSIONS: Physicians often lack the knowledge to assist patients in the management of their out-of-pocket costs for prescription drugs and they depend on pharmacists to help patients manage those costs. Computer order entry and resources available in large physician organizations improve physicians' awareness of out-of-pocket costs when prescribing.

Attitude of Health Personnel↗