Lombarts M J M H, Klazinga N S
Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Int J Qual Health Care. 2003 Apr;15(2):119-29. doi: 10.1093/intqhc/mzg020.
To improve the quality of patient care by supporting the implementation of practice-specific visitatie (external peer review) recommendations.
A descriptive evaluation of an intervention strategy (Quality Consultation). Data collection through participatory observation, telephone interviews, and a postal survey.
Twenty-five specialist group practices (67 specialists) from the specialty societies of surgeons, paediatricians, and gynaecologists, supported in their implementation efforts by two experienced management consultants.
Approximately 20 h of management consultancy. The Quality Consultation took a site-specific multifaceted implementation approach; its tool kit consisted of various management and quality improvement support methods.
Choice of recommendations supported; type of interventions offered; degree of implementation; appreciation of implementation results and process; and impact of management consultants as assessed by participants.
The level of participation was high and evaluation of the consultants and the impact of their support positive. Most implementation projects were related to strategic issues or the functioning of the specialist group. Every specialist group was offered multiple interventions, both participatory and non-participatory. The degree of implementation was rated 4.0 on a 5-point scale; the scores for the implementation result and process were 6.6 on a 10-point scale.
Visitatie seems to inherently enforce the development of management of medical specialist care. This might also be true for other external peer review models. The development of effective specialist groups deserves high priority in order to implement visitatie recommendations successfully. Management consultants can be instrumental in this process.
通过支持实施针对特定实践的访视（外部同行评审）建议来提高患者护理质量。
对一种干预策略（质量咨询）的描述性评估。通过参与观察、电话访谈和邮政调查收集数据。
来自外科医生、儿科医生和妇科医生专业协会的25个专科小组诊所（67名专科医生），由两名经验丰富的管理顾问支持其实施工作。
约20小时的管理咨询。质量咨询采用针对具体场所的多方面实施方法；其工具包包括各种管理和质量改进支持方法。
所支持建议的选择；提供的干预类型；实施程度；对实施结果和过程的评价；以及参与者对管理顾问影响的评估。
参与度很高，对顾问及其支持影响的评价为积极。大多数实施项目与战略问题或专科小组的运作有关。每个专科小组都获得了多种参与性和非参与性干预措施。实施程度在5分制中评为4.0分；实施结果和过程的得分在10分制中为6.6分。
访视似乎本质上促进了医学专科护理管理的发展。其他外部同行评审模式可能也是如此。为了成功实施访视建议，有效专科小组的发展应高度优先。管理顾问在这一过程中可发挥重要作用。
