Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Scand J Prim Health Care. 2020 Sep;38(3):352-359. doi: 10.1080/02813432.2020.1794400. Epub 2020 Jul 31.
This study aimed to explore the conditions for the Municipal Chief Medical Officers' (MCMOs) involvement in quality improvement in general practice, specifically concerning antibiotic prescribing practices.
This qualitative study consisted of semi-structured in-depth telephone interviews and group interviews with MCMOs ( = 12). The interview guide aimed to explore the MCMOs' views on their role and responsibilities regarding the quality of care in general practice. The data were analysed using systematic text condensation.
Three main themes were identified: 1) the relationship between the municipality and the general practitioner (GP), with the MCMO acting as an intermediary, 2) influencing the GPs' work and 3) antibiotic use and infection control. The MCMOs perceived themselves as liaisons between the municipalities and the GPs. They emphasized building trust, showing respect and sharing common values in their interactions with the GPs, upholding the GPs' professional autonomy. Working for quality improvement was considered a priority; however, MCMOs expressed a need for external support to establish a permanent quality improvement framework. The informants were positive about engaging in improving antibiotic prescribing practices because this combined the municipality's responsibilities for quality improvement and communicable disease control.
The MCMOs considered themselves as well-suited agents for quality improvement in general practice, as liaisons between the municipalities and the GPs. Quality improvement in general practice would benefit from a clearer structure in terms of the MCMOs' roles and responsibilities. Within communicable diseases control, the MCMOs have a clear mandate, which places antimicrobial stewardship initiatives in a favourable position amongst other areas of quality improvement.
本研究旨在探讨市首席医疗官（MCMO）参与一般实践质量改进的条件，特别是在抗生素处方实践方面。
本定性研究包括对 MCMO（ = 12）进行半结构化深入电话访谈和小组访谈。访谈指南旨在探讨 MCMO 对其在一般实践中护理质量的角色和责任的看法。使用系统文本浓缩法对数据进行分析。
确定了三个主要主题：1）市与全科医生（GP）之间的关系，MCMO 充当中间人，2）影响 GP 的工作，3）抗生素使用和感染控制。MCMO 认为自己是市与 GP 之间的联络人。他们强调在与 GP 互动时建立信任、表示尊重和分享共同价值观，维护 GP 的专业自主权。他们认为改善质量是优先事项；然而，MCMO 表示需要外部支持来建立一个永久的质量改进框架。受访者对参与改善抗生素处方实践持积极态度，因为这结合了市对质量改进和传染病控制的责任。
MCMO 认为自己是一般实践质量改进的合适代理人，是市与 GP 之间的联络人。一般实践中的质量改进将受益于更明确的 MCMO 角色和责任结构。在传染病控制方面，MCMO 有明确的任务授权，这使抗菌药物管理举措在其他质量改进领域处于有利地位。
