Roadmap for developing a national quality indicator set for general practice

Abstract

The authors describe in detail a method to develop general practice quality indicators for a regional or national population from existing validated indicators using consensus, action research and an illuminative evaluation.

Common Features of Selection Processes of Health System Performance Indicators in Primary Healthcare: A Systematic Review

“…Some of these adopted a stricter methodology opting for a rigorous systematic review (n = 5) 38 , 39 , 43 , 48 , 52 as an initial step, while the others adopted a more flexible approach to reviewing the literature and other publicly available documents (n = 13). 42 , 46 , 49 , 50 , 54 , 55 , 57 - 60 , 62 , 63 , 65 All those that did not explicitly use a literature review as part of their indicator selection process, relied heavily on adapting an existing framework into the relevant context (n = 10). 40 , 41 , 44 , 45 , 47 , 51 , 53 , 56 , 61 , 64 …”

A process for developing standards to promote quality in general practice

“…Whilst elements of the Standards development process have been captured in some of the literature, no comprehensive description of standards development in health care has been published to our knowledge (11–17). The fifth edition Standards were developed using the Delphi technique as deployed in other settings (18–20) with common elements including consensus, expert opinion, identifying opportunities and problem areas to create new standards, developing iterative drafts, piloting and testing (21–25). As described earlier, the approach is an iterative process, seeking and incorporating feedback and enhancing the scope for widespread consultation through as many channels as possible.…”

Identifying contextually relevant improvement measures, illustrated by a case of executive walkrounds

“…Furthermore, too many or irrelevant measures waste effort and reduce measurement efficacy (Weeks et al, 2008;Teare, 2014), leading to calls to reduce the number of healthcare performance measures in some countries by 75 per cent (Berwick, 2018). Hospital quality improvement project evaluations (Thor et al, 2010) and national quality indicator reviews (ni Riain et al, 2015) confirm the importance of judicious measurement selection.…”

“…Nevertheless Delphi methods have proved useful in healthcare settings, for example, to produce evidence and consensus-based indicators for cancer (Gagliardi et al, 2005) and to determine system-level indicators (Hassan and Barnett, 2002;Ni Riain et al, 2015). Detailed guides to variations in applying Delphi techniques and analysing results in healthcare settings are available (for example, Hassan and Barnett, 2002;Pereira and Alvim, 2015;Ab Latif et al, 2016;Njuangang et al, 2017).…”

“…The Delphi technique allows participation based on both professional experience and expert knowledge (Njuangang et al, 2017;Carlin and Chesters, 2019). However, no single criterion is used to identify consensus and different researchers have applied divergent data collection and analysis tools (for example, ni Riain et al, 2015;Ab Latif et al, 2016;Njuangang et al, 2017;Carlin and Chesters, 2019).…”