Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study

Background: There is a substantial variation in how different general practices manage knowledge implementation, including the degree to which activities are collectively and formally organised. Yet, it is unclear how these differences in implementation activities affect quality of care. Aim: To inv...

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Main Authors: Jette V Le, Jesper Lykkegaard, Line B Pedersen, Helle Riisgaard, Jørgen Nexøe, Jeanette Lemmergaard, Jens Søndergaard
Format: Article
Language:English
Published: Royal College of General Practitioners 2017-04-01
Series:BJGP Open
Subjects:
Online Access:https://bjgpopen.org/content/1/2/bjgpopen17X100737
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author Jette V Le
Jesper Lykkegaard
Line B Pedersen
Helle Riisgaard
Jørgen Nexøe
Jeanette Lemmergaard
Jens Søndergaard
author_facet Jette V Le
Jesper Lykkegaard
Line B Pedersen
Helle Riisgaard
Jørgen Nexøe
Jeanette Lemmergaard
Jens Søndergaard
author_sort Jette V Le
collection DOAJ
description Background: There is a substantial variation in how different general practices manage knowledge implementation, including the degree to which activities are collectively and formally organised. Yet, it is unclear how these differences in implementation activities affect quality of care. Aim: To investigate if there are associations between specific formalised knowledge implementation activities and quality of care in general practices, exemplified by the use of spirometry testing. Design & setting: A nationwide cross-sectional study combining survey and register data in Denmark. Method: An electronic questionnaire was distributed to GPs, and data on spirometry testing among first-time users of medication against obstructive lung diseases were obtained from national registers. Associations were investigated using multilevel mixed-effect logit models. Results: GPs from 1114 practices (58%) responded, and 33 788 patients were linked to a responding practice. In partnership practices, the frequency of interdisciplinary and GP meetings affected the quality of care. Interdisciplinary and GP meetings held on a weekly basis were significantly associated with a higher level of quality of care and this was measured by the odds ratio (OR) of patients having spirometry. The development of practice protocols and standard recordings in the electronic medical record (EMR) for a range of disease areas compared with few or no areas at all also impacted the quality of care level provided. The effect of formalised implementation activities was not as evident in single-handed practices as in partnerships. Conclusion: This study provides valuable knowledge for GPs who aim to organise their practice in a way that supports implementation and quality improvement most effectively. Also, results may be useful for managers of implementation strategies and quality improvement initiatives when planning future activities.
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spelling doaj.art-d48cee63dca3459781ed958d6c0d26fd2022-12-22T03:58:38ZengRoyal College of General PractitionersBJGP Open2398-37952017-04-011210.3399/bjgpopen17X100737Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional studyJette V Le0Jesper Lykkegaard1Line B Pedersen2Helle Riisgaard3Jørgen Nexøe4Jeanette Lemmergaard5Jens Søndergaard6Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, DenmarkResearch Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, DenmarkResearch Unit of General Practice, Department of Public Health and COHERE, Department of Business Economics, University of Southern Denmark, Odense, DenmarkDepartment of Public Health, University of Southern Denmark, Odense, DenmarkResearch Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, DenmarkDepartment of Marketing & Management, University of Southern Denmark, Odense, DenmarkResearch Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, DenmarkBackground: There is a substantial variation in how different general practices manage knowledge implementation, including the degree to which activities are collectively and formally organised. Yet, it is unclear how these differences in implementation activities affect quality of care. Aim: To investigate if there are associations between specific formalised knowledge implementation activities and quality of care in general practices, exemplified by the use of spirometry testing. Design & setting: A nationwide cross-sectional study combining survey and register data in Denmark. Method: An electronic questionnaire was distributed to GPs, and data on spirometry testing among first-time users of medication against obstructive lung diseases were obtained from national registers. Associations were investigated using multilevel mixed-effect logit models. Results: GPs from 1114 practices (58%) responded, and 33 788 patients were linked to a responding practice. In partnership practices, the frequency of interdisciplinary and GP meetings affected the quality of care. Interdisciplinary and GP meetings held on a weekly basis were significantly associated with a higher level of quality of care and this was measured by the odds ratio (OR) of patients having spirometry. The development of practice protocols and standard recordings in the electronic medical record (EMR) for a range of disease areas compared with few or no areas at all also impacted the quality of care level provided. The effect of formalised implementation activities was not as evident in single-handed practices as in partnerships. Conclusion: This study provides valuable knowledge for GPs who aim to organise their practice in a way that supports implementation and quality improvement most effectively. Also, results may be useful for managers of implementation strategies and quality improvement initiatives when planning future activities.https://bjgpopen.org/content/1/2/bjgpopen17X100737general practicequality of health careevidence-based practiceorganization and administrationcross-sectional study
spellingShingle Jette V Le
Jesper Lykkegaard
Line B Pedersen
Helle Riisgaard
Jørgen Nexøe
Jeanette Lemmergaard
Jens Søndergaard
Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
BJGP Open
general practice
quality of health care
evidence-based practice
organization and administration
cross-sectional study
title Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
title_full Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
title_fullStr Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
title_full_unstemmed Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
title_short Are formalised implementation activities associated with aspects of quality of care in general practice? A cross-sectional study
title_sort are formalised implementation activities associated with aspects of quality of care in general practice a cross sectional study
topic general practice
quality of health care
evidence-based practice
organization and administration
cross-sectional study
url https://bjgpopen.org/content/1/2/bjgpopen17X100737
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