Quality Improvement (QI) in Primary Care Setting
There has been growing awareness of the need to improve quality across health care and general practice, driven by a need to reduce inequalities in health care and the need to effectively translate evidence into practice, and by the changing expectations of patients and carers. However, until now, activities to address this need have often been variable.
Improvement in general practice can involve examining practice structures, systems and clinical care. Improvement needs to be based on evidence produced by the practice’s own data. This data can be gathered from patient or staff feedback, an audit of clinical databases, or the analysis of near misses and mistakes.
Royal Australian Collage of General Practitioner 4th Standard Requirement
The RACGP directs practices to engage in quality improvement activities to improve quality and safety for patients in areas such as practice structures, systems and clinical care. Decisions on changes should be based on practice data and achieving improvements, and requires the collaborative effort of the practice team. All members of the team should feel empowered to contribute to:
Criterion 2.1.2 Patient feedback (RACGP website)
Criterion 1.3.1 Health promotion and preventive care (RACGP website)
Quality Improvement is an organised and continuous activity that assesses and evaluates health services to improve practice processes and quality of care. It is an essential business activity to improve quality and safety for patients in areas such as practice structures, systems and clinical care.
Five skills required in a model for quality improvement are:
- Being clear about what is going to be accomplished
- Measuring change and being able to recognise whether this change constitutes improvements
- Having a series of good ideas about quality alternatives to current practice
- Being able to test real changes on a small scale and making further adjustments accordingly
- Team activity engaging in opportunities for the GPs and other staff members to come together as a team to consider quality improvement. QI can relate to many areas of a practice, and achieving improvements will require the collaborative effort of the practice team as a whole.
Accreditation can help practices achieve this by providing an opportunity to reflect on all aspects of the practice.