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首页> 美国卫生研究院文献>Quality in Health Care : QHC >Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non-physician observers
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Practice visits as a tool in quality improvement: mutual visits and feedback by peers compared with visits and feedback by non-physician observers

机译：练习访问作为改善质量的工具：同行之间的相互访问和反馈与非医师观察员的访问和反馈相比

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Objective - To evaluate and compare the effects of two programmes of assessment of practice management in a practice visit: mutual visits and feedback by peers compared with visits and feedback by non- physician observers. Design - Prospective, randomised intervention study, with follow up after one year. Setting - General practices in the Netherlands in 1993 and 1994. Subjects - A total of 90 general practitioners (GPs) in 68 practices; follow up after one year comprised 81 GPs in 62 practices. Main measures - Scores on indicators and dimensions of practice management in the visit instrument to assess practice management and organisation (a validated Dutch method to assess practice management in a practice visit). Change was defined as the difference in score between the first visit and the visit after one year on 208 indicators and on 33 dimensions of practice management. Results - Data of 44 mutual visits by peers were compared with data of 46 visits by non-physician observers. After a year both programmes showed improvements on many aspects of practice management, but different aspects changed in each of the two programmes. After mutual practice visits, GPs scored significantly higher on content of the doctor's bag, on collaboration with colleagues, on collaboration with other care providers, and on accessibility of patient information than after a visit by a non-physician observer. The visits by non-physician observers resulted in a higher score on extent of use of records and on assessment on outcome and year report. Conclusion - Change after mutual practice visits and feedback by peers is more marked than after a visit and feedback by a non-physician observer.
机译：目的-评估和比较实践访问中两个实践管理评估计划的效果：同伴的互访和反馈与非医师观察员的访问和反馈相比较。设计-前瞻性随机干预研究，一年后进行随访。背景-1993年和1994年在荷兰的一般执业。科目-共有90种全科医生，共有68种执业；一年后的随访包括62种做法的81名GP。主要衡量指标-访问工具中用于评估实践管理和组织的实践管理指标和维度得分（一种经过验证的荷兰评估实践访问中实践管理的方法）。改变被定义为第一次访问和一年后访问之间在208项指标和33个方面的评分差异。结果-将同伴的44次互访数据与非医师观察员的46次互访数据进行了比较。一年后，这两个计划在实践管理的许多方面都表现出了进步，但是两个计划的每个方面都发生了变化。经过共同练习探访时，全科医生在医生包的内容上得分高得多，与同事合作，与其他护理提供者合作，以及患者信息的可访问性非医师观察员。非医师观察员的访问导致在记录使用范围和结果评估上得分更高年度报告。结论-互访和反馈后发生变化与非医师拜访和反馈后相比，同伴的标记更为明显观察者。

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