Initiating change in primary care, the Vännäs Project. Its realization and evaluation

It is expected that the development of primary care shall add qualities such as accessibility, continuity and cooperation to the health care system. In Sweden the health care system is mainly based on hospital care, but projects organized outside hospital settings have been tested, the Primary Health Care Center of Vännäs being one of many. This article reports on the aims of the Vännäs Project and the means used to accomplish postulated goals. In a study conducted between 1976 and 1980, we analyzed the interaction of the aims, means and evaluation of the project. The need for a functioning interplay among the three components was emphasized in order to promote sound planning and knowledgeable decisions. A model for development work in primary care is proposed to give stability and structure to thoughts and ideas when changes are being considered. To further primary care, it is necessary to proceed with a clear structure in order to prevent chance and fashion from running the development.