Perera G A Roshan, Dowell Anthony C, Morris Caroline J
Department of the Dean, School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington South, New Zealand.
Aust Health Rev. 2013 Feb;37(1):98-103. doi: 10.1071/AH11097.
In 2009, the Royal New Zealand College of General Practitioners commissioned the development of a framework to facilitate quality-improvement activity in primary care settings. This paper outlines the development of the framework, which integrates concepts of quality with the reality of practice-based clinical care, and discusses its value for primary care quality improvement.
Framework development involved: (1) literature review of theoretical approaches to healthcare quality; (2) field work utilising a mixed methods approach to obtain empirical data; and (3) model design.
Primary care practitioners are juggling competing priorities. Models and tools that promote quality-related activity at practice level need to take into account, and incorporate by design, day-to-day clinical and practice functions.
The quality framework identifies the components of primary care practice and locates this model within the concepts and activities necessary for quality improvement. It may be used by primary care organisations and practices to facilitate focussed quality-improvement activity and self-directed process review. The framework was developed for, and within a New Zealand primary care setting, and is applicable internationally and within other healthcare settings.
2009年，新西兰皇家全科医生学院委托制定一个框架，以促进基层医疗环境中的质量改进活动。本文概述了该框架的制定过程，该框架将质量概念与基于实践的临床护理现实相结合，并讨论了其对基层医疗质量改进的价值。
框架开发包括：（1）对医疗质量理论方法的文献综述；（2）采用混合方法进行实地考察以获取实证数据；（3）模型设计。
基层医疗从业者要应对相互冲突的优先事项。在实践层面促进与质量相关活动的模型和工具需要考虑并通过设计纳入日常临床和实践功能。
质量框架确定了基层医疗实践的组成部分，并将该模型置于质量改进所需的概念和活动之中。基层医疗组织和机构可使用它来促进有针对性的质量改进活动和自我指导的过程审查。该框架是在新西兰基层医疗环境中制定的，适用于国际和其他医疗环境。
