Variations in the ability of general medical practitioners to apply two methods of clinical audit: a five‐year study of assessment by peer review

Abstract

A significant proportion of GPs may be unable to adequately apply audit methods, potentially raising serious questions about the effectiveness of clinical audit as a health care improvement policy in general medical practice.

Verifying appraisal evidence using feedback from trained peers: views and experiences of Scottish GP appraisers

“…[11][12][13][15][16][17][18][19][20][21][22][23] However, further evidence from a range of GP groups as to its overall utility is necessary to inform future development. 24,25 GP appraisers are a key group with important professional insights into the strengths and weakness of the appraisal system and how it may be enhanced.…”

Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data

“…Proposed modifications to improve the validity and reliability of peer review include use of multiple reviewers, objective or explicit assessment procedures, elimination of systemic reviewer bias, higher standards for peer reviewers, and assessment of patients’ outcomes 14 23–29. Nevertheless, peer review practices remain variable across healthcare systems and institutions 30 31. While some top-down or system-level guidance may be needed to mitigate these barriers, local efforts to encourage provider engagement in peer review processes may facilitate organisational learning and quality improvements 32 33…”

Levels of agreement on the grading, analysis and reporting of significant events by general practitioners: a cross-sectional study

“…merging this information with further evidence from 181 categorised significant events analysed by GPs collected as a part of (unpublished) research involving a regional educational peer review model23 to develop a preliminary taxonomy of significant events in general medical practice.…”

“…This is encouraging given the difficulty for a substantial minority of GPs in identifying, prioritising and analysing significant events 15 17 23. However there is no uniformly agreed definition of what constitutes a healthcare “significant event” and only a single broad-based attempt has been published 3.…”

“…Given the complexity and uncertainty in general medical practice, SEA may offer both an understanding of where care processes can fail patients and the means to implement systemic change in relatively non-bureaucratic organisations 4. However we cannot assume that even if practitioners are prepared to analyse an event, they will be able to do so effectively and consistently 23. Issues such as team dynamics, lack of education and training, selectivity of events and humanistic and emotional factors can act as barriers to the effective analysis of events 25…”