[Family practice quality circles between goals and reality--an interaction analysis]

Quality circles are considered a key method for quality assurance in health care. However, there is a lack of systematic evaluation for quality circles in general practice, especially regarding the process quality of quality circle work. This article presents the results of an interaction analysis completing the systematic evaluation of quality circles in general practice in a region of south Germany. Using the so-called conference encoding method for interaction analysis we analyzed 7 out of 25 evaluated quality circles and 2348 interactions between the quality circle members. The participation rate of the moderators is high compared to the relative low contribution of the group members to the quality circle work. We could show that quality circles work topic-oriented, there is a wide exchange of experience between the group members and the group climate is positive. However, there were almost no specific activities to develop guidelines for diagnostic and therapeutic procedures. The results showed a significant discrepancy between the aims of quality circles and their practical realisation. Besides improved option for information and training programs for moderators and participants, we recommend further evaluation studies complemented with specific analysis of the process quality for example with the conference encoding method.