Background GPs providing patient-centred care (PCC) is embedded in international health care policies due to its positive impact on patients and potential to lower health care costs. However, what is currently known about GP-delivered PCC is unknown. Objective To synthesize literature investigating GP-delivered PCC and address ‘what is currently known about GP-delivered PCC?’ Method A systematic literature search was conducted between June and July 2018. Eligible articles were empirical, full-text studies published in English between January 2003 and July 2018, related to at least three of the four dimensions of PCC described by Hudon et al. (2011), and related to preventative, acute, and/or chronic care by GPs. Following screening, full-text articles were independently assessed for inclusion by two investigators. Data were extracted and quality assessed by two researchers. Findings on PCC were analysed thematically (meta-synthesis). Results Thirty medium- to high-quality studies met the inclusions criteria. Included studies utilized varied designs, with the most frequent being quantitative, cross-sectional. A theoretical model of PCC was synthesized from included studies and contained four major components: (i) understanding the whole person, (ii) finding common ground, (iii) experiencing time and (iv) aiming for positive outcomes. Harms of PCC were rarely reported. Conclusions Four overarching theoretical components of PCC relate to elements of the consultation and experience of time. These components can be used to inform the development of toolkits to support GPs and general practice organizations in pursuit of PCC as well as tools to measure patient-centredness.

Background Dietitians working in private practices in primary settings provide nutrition care to support individuals with the prevention and management of chronic disease. A better understanding of the type and usage of data collected by dietitians in this setting may provide insights to optimise the effectiveness and impact of the workforce. The present study explored the perceptions of leading Australian private practice dietitians on the collection and usage of data in their practice. Methods A qualitative descriptive study of Australian private practice dietitians, recruited by snowball sampling, was conducted on their perceptions and attitudes towards collecting and using data. Data were collected by semi‐structured interviews and all interview data were thematically analysed. Results Twenty‐three dietitians participated. Five themes emerged: (i) collecting data is challenging, nuanced, unclearly defined and therefore not routinely carried out; (ii) consistent data collection processes are impeded by the diversity of practise and practices; (iii) business‐related data collection is essential for sustainable dietetic services; (iv) clinical outcomes are fundamental to dietetic services; and (v) standardised, integrated systems are needed to enable routine data collection and synthesis. Conclusions Our findings demonstrate the rudimentary role business acumen has in practice viability and provides evidence to potentially re‐shape the future of dietetic education in Australia. Private practice dietitians may benefit from tools and training that enable consistent collection of data about their services. Such data could enable benchmarking across the workforce and contribute to a broader understanding of dietetic impact on public health.

Background Patients, providers and health care organisations benefit from an increased understanding and implementation of patient-centred care (PCC) by general practitioners (GPs). This study aimed to evaluate and advance a theoretical model of PCC developed in consultation with practising GPs and patient advocates. Methods Qualitative description in a social constructivist/interpretivist paradigm. Participants were purposively sampled from six primary care organisations in south east Queensland/northern New South Wales, Australia. Participants engaged in focus group discussions where they expressed their perceptions, views and feelings of an existing PCC model. Data was analysed thematically using a constant-comparison approach. Results Three focus groups with 15 patient advocates and three focus groups with 12 GPs were conducted before thematic saturation was obtained. Three themes emerged: i) the model represents the ideal, ii) considering the system and collaborating in care and iii) optimising the general practice environment. The themes related to participants’ impression of the model and new components of PCC perceived to be experienced in the ‘real world’. The data was synthesised to produce an advanced model of PCC named, “Putting Patients First: A Map for PCC”. Conclusions Our revised PCC model represents an enhanced understanding of PCC in the ‘real world’ and can be used to inform patients, providers and health organisations striving for PCC. Qualitative testing advanced and supported the credibility of the model and expanded its application beyond the doctor-patient encounter. Future work could incorporate our map for PCC in tool/tool kits designed to support GPs and general practice with PCC.

Aim To identify minimum reporting standards for assessing the processes and outcomes of Australian primary care dietetics practice. Methods A sequential, mixed‐method, exploratory process with peer‐nominated Australian ‘thought leaders’. A literature review was undertaken to identify possible standards, followed by semi‐structured qualitative interviews with thought leaders. Content analysis was used to identify a comprehensive group of items that could inform evidence‐based reporting standards. Two rounds of a modified Delphi survey were conducted with the same thought leaders to seek consensus on the most relevant items. Individual items were analysed for content validity, and those with a rating of excellent item‐content validity (index >0.78) were included as evidenced‐based standards for primary care practice. Results Twenty‐six thought leaders (response rate: 87%) from all mainland Australian states completed a qualitative interview and two rounds of modified‐Delphi consensus surveys. Items were identified and categorised into three domains: business, clinical, and implementation. Content analysis identified 216 items published or used in practice by the thought leaders. After two rounds of consensus review, 97 items (45 business, 33 clinical, and 19 implementation) achieved excellent consensus ratings. Combining these items into a standardised tool, the scale‐content validity index average was >0.90, which is considered excellent content validity. Conclusions This study has identified minimum reporting standards for evidence‐based process and outcome assessments in primary care dietetics practice in Australia. Incorporating such standards into a standardised tool could enable benchmarking across the dietetics workforce and contribute to a broader understanding of the dietetic impact on public health.

Background: Quality improvement strategies have been widely applied in health care; however, little is known about their use in primary care dietetics. This review aims to describe and evaluate the effectiveness of quality improvement strategies that seek to improve patient outcomes by enhancing dietetic care compared to standard dietetic care. Methods: The study employed a systematic review and meta-analysis design following PRISMA guidelines and included studies up to March 2021. Studies were included if they used a randomised controlled trial (RCT) design to evaluate the effect of a quality improvement strategy applied to care delivered by a dietitian on patient outcomes. A meta-analysis was conducted where there were sufficient studies with homogeneous populations and outcome measures. Results: Twelve RCTs (n = 1604) met the inclusion criteria for review and five studies (n = 511) were eligible for meta-analysis for glycated haemoglobin in patients with type 2 diabetes. The most frequently reported quality improvement strategies addressed disease management programs (58%), patient education (67%), group care (42%) and patient self-management (42%). A positive intervention effect was reported in 50% of the included studies. A low grade of evidence supported a positive intervention effect for quality improvement intervention by a dietitian for glycated haemoglobin (pooled mean difference = −0.39% with 95% confidence interval = −0.70 to −0.08, p = 0.01) in n = 511 patients with type 2 diabetes mellitus. Conclusions: Interventions aimed at enhancing quality in primary care dietetic practice support improvements in patient outcomes. Further research on quality improvement interventions for patient outcomes is required to strengthen the evidence base in this important topic. K E Y W O R D S nutrition care, primary care, quality improvement Keypoints • This systematic review and meta-analysis synthesises results from 12 randomised controlled trials (RCTs) to evaluate the effectiveness of quality improvement strategies with respect to improving patient outcomes. • Quality improvement interventions most frequently aimed to improve effectiveness, efficiency and person-centredness, whereas no interventions aimed to improve the timeliness or safety of care.