Effectiveness and efficiency of a practice accreditation program on cardiovascular risk management in primary care: study protocol of a clustered randomized trial

Nouwens, Elvira; Lieshout, Jan van; Adang, Eddy; Bouma, Margriet; Braspenning, Jozé; Wensing, Michel

doi:10.1186/1748-5908-7-94

Cited by 8 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A qualitative study was conducted, which was linked to a cluster randomized trial of the practice accreditation program in the Netherlands [ 8 ]. All participating practices participated in the practice accreditation program and all were invited for the qualitative study.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of impact of a practice accreditation program in primary care: a qualitative study

2015

Self Cite

View full text Add to dashboard Cite

BackgroundPractice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building on the experiences of primary care professionals who had participated in this program.MethodsAn interview study was done to document the experiences of 33 participating primary care professionals and used to identify determinants of outcomes. The Consolidated Framework for Implementation Research (CFIR) was used as framework for the qualitative analysis.ResultsAfter analyzing 23 interviews saturation was reached. The practice accreditation program is based on structured quality improvement, but only some of its elements were identified as determinants of impact. Factors that were perceived to facilitate implementation of the program were: designating one person responsible for the program, ensuring clear lines of communication within the whole practice team and having affinity with or stimulate enthusiasm for improving quality of care. Contextual factors such as participation in a care group and being connected to the GP educational institute were important for actual change. The accreditation program was perceived to have positive effects on team climate and commitment to quality of care in the practice team. The perception was that patient care was not directly influenced by the accreditation program. Receiving a certificate for completing the accreditation program seemed to have little added value to participants.ConclusionsPractice accreditation may have positive outcomes on quality of care, but not all planned elements may contribute to its outcomes. Both factors in the accreditation process and in the context were perceived as determinants of quality improvement. The challenge is to build on facilitating factors, while reducing the elements of accreditation that do not contribute to its impact.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0294-x) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

“…All interviews were held by one person (EN), a health scientist and physiotherapist. All 41 practices included in the cluster randomized trial [ 8 ] were approached to participate in the interviews. An interview guide was used and was adjusted during the process of interviewing based on interim reviewing of the results.…”

Section: Methodsmentioning

confidence: 99%

Determinants of impact of a practice accreditation program in primary care: a qualitative study

2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…We have failed to mention the covariates included in this study with registration of this trials. However, the covariates were discussed in the published studyprotocol [13] .…”

Section: Discussionmentioning

confidence: 99%

“…The study design was a two-arm cluster randomized controlled trial with a block design, taking primary care practices as units of clustering, with measurements at baseline and at follow-up in independent samples of patients. The study protocol was published elsewhere [13] . The trial was registered at clinicaltrials.gov nr NCT00791362, http://www.clinicaltrials.gov/ct2/show/NCT00791362?term=NCT00791362&rank=1…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Improvement Plans in Primary Care Practice Accreditation: A Clustered Randomized Trial

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundAccreditation of healthcare organizations is a widely used method to assess and improve quality of healthcare. Our aim was to determine the effectiveness of improvement plans in practice accreditation of primary care practices, focusing on cardiovascular risk management (CVRM).MethodA two-arm cluster randomized controlled trial with a block design was conducted with measurements at baseline and follow-up. Primary care practices allocated to the intervention group (n = 22) were instructed to focus improvement plans during the intervention period on CVRM, while practices in the control group (n = 23) could focus on any domain except on CVRM and diabetes mellitus. Primary outcomes were systolic blood pressure <140 mmHg, LDL cholesterol <2.5 mmol/l and prescription of antiplatelet drugs. Secondary outcomes were 17 indicators of CVRM and physician's perceived goal attainment for the chosen improvement project.ResultsNo effect was found on the primary outcomes. Blood pressure targets were reached in 39.8% of patients in the intervention and 38.7% of patients in the control group; cholesterol target levels were reached in 44.5% and 49.0% respectively; antiplatelet drugs were prescribed in 82.7% in both groups. Six secondary outcomes improved: smoking status, exercise control, diet control, registration of alcohol intake, measurement of waist circumference, and fasting glucose. Participants' perceived goal attainment was high in both arms: mean scores of 7.9 and 8.2 on the 10-point scale.ConclusionsThe focus of improvement plans on CVRM in the practice accreditation program led to some improvements of CVRM, but not on the primary outcomes.ClinicalTrials.gov NCT00791362

show abstract

“…1,2 In addition to formative use for internal audit and feedback, 3,4 QIs are increasingly used for summative purposes such as external evaluation, 5 benchmarking, 6 pay for performance, 7 and public reporting. 8 To warrant reliable information, QIs should be systematically developed and tested for validity, acceptability, feasibility, reliability, and sensitivity to change.…”

mentioning

confidence: 99%

Evaluation of Quality Indicators for Dutch Community Pharmacies Using a Comprehensive Assessment Framework

Schoenmakers¹,

Teichert²,

Braspenning³

et al. 2015

JMCP

Self Cite

View full text Add to dashboard Cite

BACKGROUND: In 2008, the Dutch Health Care Transparency Programme (Zichtbare Zorg) was set up to develop and apply quality indicators (QIs) for health care. These QIs serve a range of purposes and can be categorized into those for internal use-for meeting quality standards and to continuously measure improvement (formative)-and external use-to enable patients and health insurance companies to distinguish between health care providers (summative). In order to assess the validity of QIs, a comprehensive Indicator Assessment Framework (IAF) was developed. This framework specifies the following criteria for validation: content validity, absence of selection bias, absence of measurement bias, and statistical reliability. Because of the intended summative use, the IAF was used for structural assessment of the QIs set for Dutch community pharmacists.

show abstract

Effectiveness and efficiency of a practice accreditation program on cardiovascular risk management in primary care: study protocol of a clustered randomized trial

Cited by 8 publications

References 22 publications

Determinants of impact of a practice accreditation program in primary care: a qualitative study

Determinants of impact of a practice accreditation program in primary care: a qualitative study

Effectiveness of Improvement Plans in Primary Care Practice Accreditation: A Clustered Randomized Trial

Evaluation of Quality Indicators for Dutch Community Pharmacies Using a Comprehensive Assessment Framework

Contact Info

Product

Resources

About