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[Promoting quality and quality circles from the viewpoint of established physicians--representative Bremen and
M Beyer1, F M Gerlach, A Breull
1Abteilung Allgemeinmedizin, Medizinische Hochschule Hannover.
Insights
Most ambulatory care physicians in Germany see the need for quality improvement (QI) and are interested in joining quality circles (QCs). However, concerns about control and workload need to be addressed to increase participation in QI initiatives.
Area of Science:
- Medical Quality Improvement
- Health Services Research
- Physician Education
Context:
- Quality improvement (QI) is crucial in ambulatory care.
- Physician attitudes towards QI and peer review groups (quality circles or QCs) are not well understood in Germany.
- This study surveyed physicians in Saxony-Anhalt and Bremen.
Purpose:
- To assess ambulatory care physicians' attitudes toward quality improvement.
- To determine physicians' intentions to join quality circles (QCs).
- To understand physicians' expectations and concerns regarding QCs.
Summary:
- A large survey (n=2412) in Germany revealed that most physicians believe QI is necessary.
- Over 50% intended to join a QC, expecting practical assistance and experience exchange.
- Key barriers included professional/private duties, fear of control, and perceived inefficiency.
Impact:
- Findings highlight the need for policies addressing physician concerns to enhance QI participation.
- Understanding physician motivations and impediments is key to designing effective quality circles.
- Tailored approaches are necessary to boost engagement in quality improvement initiatives.
Research Question:
To study the attitudes of ambulatory care physicians towards quality improvement, the intentions to join quality circles (QCs, peer review groups) and the expectations directed towards them.
Methods/Setting:
Survey with a five-page questionnaire posted to all ambulatory care physicians in the German states of Saxony-Anhalt (n = 3139) and Bremen (n = 1131).
Results:
Response rates were 61.8% in Saxony-Anhalt and 41.7% in Bremen. 2412 questionnaires were available in this largest survey on that topic in Germany. Necessity of quality improvement (QI) in ambulatory care was approved by the majority of the respondents (1.7 on a 5-point Lickert scale). Concerns existed about a rise in control and the risk of abuse of QI measures. 56.4% in Saxony-Anhalt and 52.3% in Bremen had the intention to join a QC. Motives and impediments of participation in QCs were investigated by content analysis. A causal dominance analysis was performed to identify the key elements for the decision to participate. The main benefits of QC-participation were expected as assistance in daily practice and exchange of experiences. The major obstacles were professional and private duties, fear of control and inefficiency.
Conclusions:
Policies that could be adequate to rise motivations and tackle on widespread fears should be purposely adapted to the needs and expectations of the physicians.