Mercer Stewart, Gillies John, Fitzpatrick Bridie
Professor of Primary Care and Multimorbidity, Usher Institute, University of Edinburgh, Edinburgh, UK
Honorary Professor, Usher Institute, University of Edinburgh, Edinburgh, UK.
BJGP Open. 2020 Dec 15;4(5). doi: 10.3399/bjgpopen20X101112. Print 2020 Dec.
The concept of GP clusters is derived from 'quality circles' in general practice in Europe and Canada. GP clusters commenced across Scotland in 2016 to improve the quality of care of local populations.
To determine GPs' views on clusters, and the robustness of bespoke questions about them.
DESIGN & SETTING: A cross-sectional national survey of work satisfaction of GPs in Scotland took place, which was conducted in July 2018-October 2018.
An analysis of bespoke questions on GP clusters was undertaken. The questions were completed by quality leads (QLs) and all other GPs in a nationally representative sample of GPs.
In total, 2456 responses were received from 4371 GPs (56.4%). QLs reported that clusters were meeting regularly, and were friendly and well organised but not always productive. Support for cluster activity (data, health intelligence, analysis, quality improvement methods, advice, leadership, and evaluation) was suboptimal. Factor analysis identified two separate constructs (cluster meetings [CMs] and cluster support [CS]), which were minimally influenced (<2%) by GP and practice characteristics. Non-QLs (75% of all GPs) were generally satisfied with the two-way communication with the cluster QLs, but the great majority (>70%) reported no positive changes in various aspects of quality improvement. Factor analysis of these items indicated two constructs (cluster knowledge and engagement [CKE] and cluster quality improvement [CQI]), which were minimally affected by GP and practice characteristics.
GP clusters are 'up and running' in Scotland but are at an early stage in terms of perceived impact and appear to be in need of more support in order to improve quality of care. The bespoke questions developed on clusters have robust construct validity, suitable for future surveys.
全科医生（GP）群组的概念源自欧洲和加拿大全科医疗中的“质量圈”。2016年起，全科医生群组在苏格兰各地启动，旨在提高当地居民的医疗服务质量。
确定全科医生对群组的看法，以及有关群组的定制问题的稳健性。
于2018年7月至2018年10月对苏格兰全科医生的工作满意度进行了一项全国性横断面调查。
对有关全科医生群组的定制问题进行了分析。这些问题由质量负责人（QLs）以及全国具有代表性的全科医生样本中的所有其他全科医生完成。
共收到来自4371名全科医生（56.4%）的2456份回复。质量负责人报告称群组定期开会，氛围友好且组织良好，但并非总是富有成效。对群组活动（数据、健康情报、分析、质量改进方法、建议、领导力和评估）的支持并不理想。因子分析确定了两个独立的结构（群组会议[CMs]和群组支持[CS]），它们受全科医生和诊所特征的影响极小（<2%）。非质量负责人（占所有全科医生的75%）总体上对与群组质量负责人的双向沟通感到满意，但绝大多数（>70%）报告称在质量改进的各个方面没有积极变化。对这些项目的因子分析表明有两个结构（群组知识与参与[CKE]和群组质量改进[CQI]），它们受全科医生和诊所特征的影响极小。
全科医生群组在苏格兰已“启动并运行”，但就感知到的影响而言尚处于早期阶段，并且似乎需要更多支持以提高医疗服务质量。针对群组开发的定制问题具有稳健的结构效度，适用于未来的调查。
