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在国家全科医学认证计划下,自我评估和评估员评估对现场访问表现的影响。

The impact of self-assessment and surveyor assessment on site visit performance under the National General Practice Accreditation scheme.

机构信息

School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Balaclava Road, North Ryde, Sydney, NSW 2112, Australia.

Quality Practice Accreditation, South Gundagai, NSW, Australia.

出版信息

Aust Health Rev. 2024 Jun;48(3):222-227. doi: 10.1071/AH23235.

Abstract

Objective There is a need to undertake more proactive and in-depth analyses of general practice accreditation processes. Two areas that have been highlighted as areas of potential inconsistency are the self-assessment and surveyor assessment of indicators. Methods The data encompass 757 accreditation visits made between December 2020 and July 2022. A mixed-effect multilevel logistic regression model determined the association between attempt of the self-assessment and indicator conformity from the surveyor assessment. Furthermore, we present a contrast of the rate of indicator conformity between surveyors as an approximation of the inter-assessor consistency from the site visit. Results Two hundred and seventy-seven (37%) practices did not attempt or accurately report conformity to any indicators at the self-assessment. Association between attempting the self-assessment and the rate of indicator non-conformity at the site visit failed to reach statistical significance (OR = 0.90 [95% CI = 1.14-0.72], P  = 0.28). A small number of surveyors (N  = 9/34) demonstrated statistically significant differences in the rate of indicator conformity compared to the mean of all surveyors. Conclusions Attempt of the self-assessment did not predict indicator conformity at the site visit overall. Appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified.

摘要

目的 需要对一般实践认证过程进行更积极和深入的分析。有两个领域被强调为潜在不一致的领域,即自我评估和评估员对指标的评估。

方法 数据涵盖了 2020 年 12 月至 2022 年 7 月期间进行的 757 次认证访问。混合效应多级逻辑回归模型确定了自我评估与从评估员评估中得出的指标一致性之间的关联。此外,我们还展示了评估员之间的指标一致性比率的对比,以近似现场访问中的评估员间一致性。

结果 277 家(37%)实践没有尝试或准确报告自我评估中的任何指标的一致性。尝试自我评估与现场访问中指标不一致率之间的关联未达到统计学意义(OR=0.90[95%CI=1.14-0.72],P=0.28)。少数评估员(N=9/34)与所有评估员的平均水平相比,指标一致性的比率存在统计学显著差异。

结论 自我评估的尝试并不能预测现场访问中的指标一致性。在现场访问中,评估员之间的指标评估具有适当的一致性水平。

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