ArticleQuality in health care : QHC2000
Reactions to the use of evidence-based performance indicators in primary care: a qualitative study.
Article in Quality in health care : QHC, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research.Implementation science : IS · 2019Pooled it
- Facilitators and barriers to implementing quality measurement in primary mental health care: Systematic review.Canadian family physician Medecin de famille canadien · 2010Pooled it
- Exploring implementation processes in general practice in a feedback intervention aiming to reduce potentially inappropriate prescribing: a qualitative study among general practitioners.Implementation science communications · 2021Article
- Clinical performance comparators in audit and feedback: a review of theory and evidence.Implementation science : IS · 2019Review
- "My approach to this job is...one person at a time": Perceived discordance between population-level quality targets and patient-centred care.Canadian family physician Medecin de famille canadien · 2014Article
- Can the theoretical domains framework account for the implementation of clinical quality interventions?BMC health services research · 2013Article
- Unintended consequences of implementing a national performance measurement system into local practice.Journal of general internal medicine · 2012Article
- Comparative analysis of quality assurance in health care delivery and higher medical education.Advances in medical education and practice · 2012Article
- Implementing quality indicators in intensive care units: exploring barriers to and facilitators of behaviour change.Implementation science : IS · 2010Article
- RCGP Quality Team Development programme: an illuminative evaluation.Quality & safety in health care · 2004Article
- Performance indicator scoring.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Developing primary care review criteria from evidence-based guidelines: coronary heart disease as a model.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003Article
- Research methods used in developing and applying quality indicators in primary care.Quality & safety in health care · 2002Article
- Does feedback improve the quality of computerized medical records in primary care?Journal of the American Medical Informatics Association : JAMIAArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate reactions to the use of evidence-based cardiovascular and stroke performance indicators within one primary care group.
designQualitative analysis of semi-structured interviews.
settingFifteen practices from a primary care group in southern England.
participantsFifty two primary health care professionals including 29 general practitioners, 11 practice managers, and 12 practice nurses.
main outcome measuresParticipants' perceptions towards and actions made in response to these indicators. The barriers and facilitators in using these indicators to change practice.
resultsBarriers to the use of the indicators were their data quality and their technical specifications, including definitions of diseases such as heart failure and the threshold for interventions such as blood pressure control. Nevertheless, the indicators were sufficiently credible to prompt most of those in primary care teams to reflect on some aspect of their performance. The most common response was to improve data quality through increased or improved accuracy of recording. There was a lack of a coordinated team approach to decision making. Primary care teams placed little importance on the potential for performance indicators to identify and address inequalities in services between practices. The most common barrier to change was a lack of time and resources to act upon indicators.
conclusionFor the effective implementation of national performance indicators there are many barriers to overcome at individual, practice, and primary care group levels. Additional training and resources are required for improvements in data quality and collection, further education of all members of primary care teams, and measures to foster organisational development within practices. Unless these barriers are addressed, performance indicators could initially increase apparent variation between practices.
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