Accessibility and quality improvement in primary care

January 01, 0001

Accessibility and quality improvement in primary care

Accessibility and availability of providers in primary care can be a source of patient dissatisfaction. These Dutch investigators performed a quality-improvement study in 36 general practices in the Netherlands collecting pre-intervention and post-intervention data. They measured patient satisfaction, experiences and awareness, collected practice information, and utilized the experiences of a mystery patient. The practices received feedback and developed practice-based improvement plans.

The authors report: "Eighty per cent of the improvement plans were completed or almost completed in 5 months. After the intervention, the accessibility by phone within 2 min increased significantly (10% improvement). The practices that designed an improvement plan showed a larger increase (25% improvement) than practices that did not. Patient awareness of an information leaflet and a separate telephone number for emergency calls also significantly increased (29% improvement and 12% improvement) in practices that designed improvement plans."

The authors concluded: "Feedback and practice-based improvement plans were a stimulus to work on and to improve accessibility and availability. All practices started improvement plans, but the overall effect of the changes was modest. This may be due to acceptable accessibility and availability before the intervention was introduced and to the time period of 5 months, which seemed to be too short to complete all practice-based improvement plans. The mystery patient was more satisfied with the accessibility than the real patients. This may be related to our concept of accessibility. We learned that adding a mystery patient for data collection can contribute to more objective measurements of practice accessibility than patient questionnaires alone."

Feedback and performance improvement projects can improve accessibility and patient satisfaction in primary care.

For the full abstract, click here.

Quality and Safety in Health Care 19 (3): 248-251, June 2010
© 2010 by the BMJ Publishing Group Ltd.
Improving access to primary care: the impact of a quality-improvement strategy. K Kirschner, J Braspenning, I Maassen, A Bonte, J Burgers, R Grol. Correspondence to Kirsten Kirschner: [email protected]

Category: HSR Health Services Research Keywords: accessibility, availability, primary care, feedback, mystery patient, quality improvement study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 13 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.