Discipline of General Practice, Centre of Research Excellence – Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD
Discipline of General Practice, Centre of Research Excellence – Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD.
Med J Aust. 2016 Apr 18;204(7 Suppl):S15-21. doi: 10.5694/mja16.00121.
To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities.
The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts. Part 1 involved staff in Australian primary care practices assessing how they perceived their practice met (or did not meet) each of the 13 PC-PIT elements of high-performing practices, using a 1-5 Likert scale. In Part 2, two external raters conducted an independent practice visit to independently and objectively assess the subjective practice assessment from Part 1 against objective indicators for the 13 elements, using the same 1-5 Likert scale. Concordance between the raters was determined by comparing their ratings. In-depth interviews conducted during the independent practice visits explored practice managers' experiences and perceived support and resource needs to undertake organisational improvement in practice.
Data were available for 34 general practices participating in Part 1. For Part 2, independent practice visits and the inter-rater comparison were conducted for a purposeful sample of 19 of the 34 practices. Overall concordance between the two raters for each of the assessed elements was excellent. Three practice types across a continuum of higher- to lower-scoring practices were identified, with each using the PC-PIT in a unique way. During the in-depth interviews, practice managers identified benefits of having additional QI tools that relate to the PC-PIT elements.
The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs.
在全国范围内试用初级保健实践改进工具（PC-PIT），这是一种与澳大利亚初级保健实践共同创建的组织绩效改进工具，旨在增强其对相关质量改进（QI）活动的关注。
该研究于 2015 年 3 月至 12 月在来自各种澳大利亚初级保健环境的志愿全科诊所进行。我们使用了混合方法，分两部分进行。第一部分涉及澳大利亚初级保健实践的员工，他们使用 1-5 级李克特量表评估他们认为自己的实践在多大程度上符合（或不符合）高绩效实践的 13 个 PC-PIT 要素。在第二部分，两名外部评估员对第一部分的主观实践评估进行了独立的实践访问，根据 13 个要素的客观指标，使用相同的 1-5 级李克特量表进行独立和客观的评估。评估员之间的一致性通过比较他们的评分来确定。在独立的实践访问期间进行的深入访谈探讨了实践经理在实践中进行组织改进的经验以及感知到的支持和资源需求。
共有 34 家参与第一部分的全科诊所提供了数据。对于第二部分，对 34 家实践中的 19 家进行了有目的的抽样，进行了独立的实践访问和评估员间的比较。两名评估员对每一个评估要素的总体一致性非常好。在从高到低评分的一系列实践中确定了三种实践类型，每种实践都以独特的方式使用 PC-PIT。在深入访谈中，实践经理们确定了拥有与 PC-PIT 要素相关的额外 QI 工具的好处。
PC-PIT 是一种组织绩效工具，对我们的合作伙伴和最终用户（全科诊所）是可接受、有效和相关的。我们正在与合作伙伴和最终用户合作，将 PC-PIT 嵌入现有的组织改进计划中。
