Quality Improvements, Eastern Sydney Division of General Practice, ESDGP

QA is the independent assessment of the extent to which an organisation's performance meets a set of standards.
Accreditation is a system which enables such an assessment to occur.
Advantage it is explicit and the assessment is done by an external agency.
Disadvantage the process is not genuinely owned by those being assessed; they come to regard it as simply a hurdle to be jumped over.

Continuous Quality Improvement (CQI)

CQI is a management approach that emphasises the need for all members of the organisation to be involved in continuously making improvements. The emphasis is on making small improvements using reflective practices. Organisational processes rather than people are the main focus of interest.

Advantage - the emphasis on grass roots involvement (ie. ownership from the bottom up).

Disadvantage - unless there is a reasonable commitment to measuring performance, demonstrating that quality improvement has occurred can be very subjective.

Settings

1. Corporate office = EQuIP Corporate (B. Johnston, ACHS)

2. Clinical practice = clinical governance

Clinical governance: the complementarity of three aspects of clinical practice:

(Central Bayside DGP)

1. Compliance with evidence based care;

2. Excellence in engaging patients in their own care; and

3. Development of quality systems in practices.

Within the framework, quality is enhanced through:

assisting GPs to use their own data and relevant benchmarking data;
support for building practice capability;
peer support and feedback; and
enhancing feedback from patients and other providers.

Clinical Governance

Clinical governance is central to quality in health care. It is a framework for measuring, monitoring, improving and accounting for quality of care.

There are three activities occurring at three levels.

Three activities:

Defining quality, accounting for quality, and improving quality.

Three levels:

The individual general practitioner, the primary health care team, and the primary health care group as a whole.

The Future

will include the development and evaluation of ways of involving patients in clinical governance.

To effect this strategic culture change requires consideration of:

effective systems for internal communication;
emphasis on people development;
encouragement and support of innovation;
intolerance of error or risk; and
openness with the public.

Evaluation & feedback

1. To undertake regular evaluation

To undertake an annual needs assessment of Divisional members.

To evaluate clinical meetings and other CPD activities.

To assist the Board in determining future directions and outcomes (strategic & business planning) by providing feedback of current performance against earlier goals and indicators (KPAs & KPIs) and to identify areas of professional education and development for Program Advisors and Staff, in conjunction with CEO and Board and within financial constraints.

2. To provide regular reporting

To provide regular feedback to the Board.

To report annually to the members.

To the Commonwealth on the current template (business plan format) developed by the Primary Health Care Research & Information Service (PHCRIS) which was introduced in 2001 by the GP Branch of the Commonwealth Department of Health & Ageing on the current template.

The Future

Reporting to the Commonwealth will be through two contractual mechanisms:

1. the first will be to Primary Health Care Research & Information Service (PHCRIS) on an updated/upgraded version of the current template that will enable national data to be aggregated around performance against nationally agreed KPAs and KPIs.

2. the second will be to the State Based Organisations (SBOs) via a yet to be developed template for assessing the scope of activities of Divisions and for service planning to enhance efficiency and improve management structures and integration with State services at the local level.

Keyword Marketing