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Health Needs Assessment and Quality Improvement

Health Needs Assessment and Quality Improvement. Dr Luc Seuntjens. My presentation: 3 examples. Significant event analysis European Practice Assessment Regional assessment of test-ordering and intervention using small quality groups. DISCUSSION. DISCUSSION. From needs to….quality issues.

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Health Needs Assessment and Quality Improvement

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  1. Health Needs Assessment and Quality Improvement Dr Luc Seuntjens

  2. My presentation: 3 examples • Significant event analysis • European Practice Assessment • Regional assessment of test-ordering and intervention using small quality groups DISCUSSION DISCUSSION

  3. From needs to….quality issues

  4. A large bouquet of Quality Improvement approaches • Implementation of clinical guidelines • Total Quality Management • Accreditation and Certification • Patient Empowerment and Partnership • Organisational Development methods • Indicators, accountability and transparancy • Public reporting and physician profiling • Business Process Reengineering and Business Innovation • Breakthrough Collaboratives • Clinical pathways, case management, managed care • Balanced Score Cards • Risk Management , Significant event analysis • Knowledge management • Leadership development • Etc.

  5. Quality assessment and quality improvement (Rhydderch,J Eval Clin Pract. 05)

  6. Significant event analysis: a little girl with high fever

  7. Fish bone analysis & planning improvement people infrastructure Gap of knowledge No test material Not aware of RSV epidemic Missed diagnosis of RSV infection Friday night No assistant present Laboratory does not provide test practice external Planning Improvement

  8. Significant event analysis • Describe the event in a detailed way • Analyse • What can be improved? • Plan actions

  9. Round table discussion 1 • How do you deal with significant events in your practice? • Discuss the strengths and weaknesses of significant event analysis in your specific situation.

  10. Take home messages • Needs/Quality problems should be analysed • Needs are not isolated but refer to different causes of problems: interdependency of needs. • Significant event analysis is a well-accepted and powerful tool to detect needs and initiate change.

  11. European Practice Assessment(Engels,Grol 2005) • Researchers from 6 European countries developed a set of European indicators for management of primary care • 6 national panels rated the indicators and achieved a national consensus on a large set of indicators • A pilot test in 9 countries; data collection in 30 practices / country

  12. EPA domains • Infrastructure • Staff • Information • Finance • Quality and safety

  13. EPA: the instrument Short self-administered questionnaires • Principle GP or practice manager • Individual GPs • Staff members • Patients Observer/facilitator visits the practice • Structured interview with GP/PM • Checklist

  14. The urgency bag

  15. The interview

  16. Feedback (VISOTOOL 04)

  17. Feedback (Visotool 04)

  18. Prioritize and plan improving your practice

  19. NA Planning Cycle Start

  20. Quality assessment and quality improvement (Rhydderch,J Eval Clin Pract. 05)

  21. Take home messages • Needs assessment is a team activity • Needs assessment is successful in a practice where improving quality is felt as an internal responsibility, as part of normal GP work, of identity, of professionalism (R.Grol)

  22. Quality assessment and quality improvement (Rhydderch,J Eval Clin Pract. 05)

  23. Prescription rate of antihypertensive drugs in Belgium

  24. Regional assessment of test- orderingVerstappen W, WOK, JAMA May 03 Involving peer interaction and social influence improves physician test-ordering behaviour.

  25. Feedback on test ordering Verstappen W, 2004

  26. The crucial importance of small group work Verstappen W, WOK, JAMA, 2003

  27. Round table discussion 2 Government organisations put community priorities on the "needs" agenda.For example cost- efficiency related items. How are these priorities in your country/practice integrated in your personal or practice CPD agenda?

  28. Take home messages • Needs of the community/society are to be integrated in local improvement projects • Quality groups can learn to analyse aggregated data and prioritize action plans • The power of peers: needs assessment in touch with local attitudes

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