دورية أكاديمية
Operational failures in general practice: a consensus-building study on the priorities for improvement.
العنوان: | Operational failures in general practice: a consensus-building study on the priorities for improvement. |
---|---|
المؤلفون: | Sinnott C; The Healthcare Improvement Studies (THIS) Institute, Cambridge., Alboksmaty A; The Healthcare Improvement Studies (THIS) Institute, Cambridge., Moxey JM; THIS Labs, Cambridge., Morley KI; RAND Europe, Cambridge., Parkinson S; RAND Europe, Cambridge., Burt J; THIS Labs, Cambridge., Dixon-Woods M; The Healthcare Improvement Studies (THIS) Institute, Cambridge. |
المصدر: | The British journal of general practice : the journal of the Royal College of General Practitioners [Br J Gen Pract] 2024 Apr 25; Vol. 74 (742), pp. e339-e346. Date of Electronic Publication: 2024 Apr 25 (Print Publication: 2024). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Royal College of General Practitioners Country of Publication: England NLM ID: 9005323 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1478-5242 (Electronic) Linking ISSN: 09601643 NLM ISO Abbreviation: Br J Gen Pract Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: London : Royal College of General Practitioners |
مواضيع طبية MeSH: | General Practice* , Delphi Technique* , Consensus* , Quality Improvement*, Humans ; England ; State Medicine ; General Practitioners ; Female ; Male |
مستخلص: | Background: System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which ones should be prioritised is less clear. Aim: To build consensus among GPs and patients on the operational failures that should be prioritised to improve NHS general practice. Design and Setting: Two modified Delphi exercises were conducted online among NHS GPs and patients in several regions across England. Method: Between February and October 2021, two modified Delphi exercises were conducted online: one with NHS GPs, and a subsequent exercise with patients. Over two rounds, GPs rated the importance of a list of operational failures ( n = 45) that had been compiled using existing evidence. The resulting shortlist was presented to patients for rating over two rounds. Data were analysed using median scores and interquartile ranges. Consensus was defined as 80% of responses falling within one value below and above the median. Results: Sixty-two GPs responded to the first Delphi exercise, and 53.2% ( n = 33) were retained through to round two. This exercise yielded consensus on 14 failures as a priority for improvement, which were presented to patients. Thirty-seven patients responded to the first patient Delphi exercise, and 89.2% ( n = 33) were retained through to round two. Patients identified 13 failures as priorities. The highest scoring failures included inaccuracies in patients' medical notes, missing test results, and difficulties referring patients to other providers because of problems with referral forms. Conclusion: This study identified the highest-priority operational failures in general practice according to GPs and patients, and indicates where improvement efforts relating to operational failures in general practice should be focused. (© The Authors.) |
References: | Health Serv Res. 2006 Jun;41(3 Pt 1):643-62. (PMID: 16704505) Perspect Health Inf Manag. 2013 Oct 01;10:1c. (PMID: 24159271) J Am Med Inform Assoc. 2017 Mar 1;24(2):246-250. (PMID: 28011595) BMJ. 2019 Nov 27;367:l6326. (PMID: 31776110) BMJ. 2023 May 2;381:966. (PMID: 37130600) Res Nurs Health. 2017 Jun;40(3):197-205. (PMID: 28297072) Br J Gen Pract. 2020 Oct 29;70(700):e825-e832. (PMID: 32958535) Br J Gen Pract. 2021 Jan 28;71(703):52-53. (PMID: 33495206) Br J Gen Pract. 2022 Jan 27;72(715):e148-e160. (PMID: 34844920) Trials. 2017 Jun 20;18(Suppl 3):280. (PMID: 28681707) Ann Fam Med. 2020 Mar;18(2):159-168. (PMID: 32152021) Br J Gen Pract. 2016 Feb;66(643):e128-35. (PMID: 26740606) J Med Internet Res. 2018 Dec 19;20(12):e11293. (PMID: 30567695) BMC Med Res Methodol. 2005 Dec 01;5:37. (PMID: 16321161) Perm J. 2014 Summer;18(3):33-41. (PMID: 25102517) |
فهرسة مساهمة: | Keywords: Delphi technique; general practice; operational failures; organisational efficiency; primary health care; quality improvement |
تواريخ الأحداث: | Date Created: 20240415 Date Completed: 20240425 Latest Revision: 20240502 |
رمز التحديث: | 20240502 |
مُعرف محوري في PubMed: | PMC11044020 |
DOI: | 10.3399/BJGP.2023.0321 |
PMID: | 38621805 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1478-5242 |
---|---|
DOI: | 10.3399/BJGP.2023.0321 |