[Consensus on a process of benchmarking in primary care in Barcelona]

To define the strategy, the conceptual framework, the methodology and the indicators that are needed to promote and consolidate the culture of external reference (benchmarking) as a strategy for change in Primary Care teams (PCT).

Cross-sectional, descriptive study.

Primary care services of the Barcelona City Health Region.

Two stages were distinguished. At the first stage, an adviser group was set up. This was divided into 4 focus groups in which the main lines, the conceptual framework, the sizes, the indicators and the methodology for comparing PCTs were agreed. The second stage, that of prioritization, was conducted by means of a questionnaire to opinion-formers. For each of the indicators proposed, they appraised the degree of agreement, the suitability and relevance of indicators, the capacity of PC to modify results and the practicality of the information for composing the indicators.

The involvement of professionals, their approach to improvement, and the transparency and dissemination of the evaluation were identified as strategic elements of benchmarking dynamics. In line with the basic principles of PC and the health system, 6 dimensions for evaluation were set: accessibility, effectiveness, capacity to resolve problems, longitudinality, cost-efficiency, and results. 43 of the 57 indicators prioritized gained the consensus of over 90% of the consultants.

Evaluation as a useful tool for managing PC quality has to generate improvements or changes in PCTs. The involvement of professionals in the design and development of evaluation may help both its acceptance and the implementation of the changes arising from it. The indicators used and the effect of benchmarking policy on the results of PC service delivery require evaluation.