Quality Circles (QC) ''Small Groups of Health Care Professionals - - PowerPoint PPT Presentation

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Quality Circles (QC) ''Small Groups of Health Care Professionals - - PowerPoint PPT Presentation

Oct 13, 2022 736 likes •987 views

Quality Circles (QC) ''Small Groups of Health Care Professionals who meet at regular Professionals who meet at regular intervals to increase and disseminate knowledge'' Importance of the Phenomenon Q Monitoring Results 2010 / 2012: 80%

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Quality Circles (QC)

''Small Groups of Health Care Professionals who meet at regular Professionals who meet at regular intervals to increase and disseminate knowledge''

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Importance of the Phenomenon

  • Q Monitoring Results 2010 / 2012:

– 80% of Family Physicians. Pediatricians and Specialists in Internal Medicine working in ambulatory care take part in QCs!

  • Swiss Association of Quality in Medicine (SAQM) 2013:
  • Swiss Association of Quality in Medicine (SAQM) 2013:

– 55% of all Swiss Medical Societies recommend QCs – 35% of all of all Swiss Medical Societies have developed networks for QCs Other Organizations (State Associations = Kantonale Gesellschaften): – 45% of all State Associations of Medicine recommend QCs – 14% of all State Associations of Medicine have developed networks for QCs

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Do QC work?

''overall effect'' – Change in prescription habits (Welschen 2004; Niquille, 2008 /2 010; Wensing,

2009; Bugnon, 2012)

Components

– Facilitation (Dogherty et al., 2010, Baskerville

et al., 2012)

– Workshop (O‘Brian, 2001 ,Forsetlund, 2009)

– Change in test ordering (doctors become more specific) (Verstappen, 2003 and 2004)a/b

– Outreach visits (O‘Brian, 2007) – Audit and feedback (Ivers, 2012) – Use of local opinion leaders (Flodgren,

2011)

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Workshop

  • Imagine Quality Circles who succeed!

– Why do they work?

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Workshop

  • Imagine Quality Circles who fail!

– Why do they fail?

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Thank you! You just helped med to find underlying theories…

  • Confirmation / validation of discussions with

stakholders in Switzerland Underlying theories

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Data/Information/Knowledge

7 SENSKY, T. 2002. Knowledge management. Advances in Psychiatric Treatment, 8, 387-395. Quality Circle

Quality Circles

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What is Quality? The Level of Excellence of a Service

  • Aspects:

– Structure – Structure – Process – Outcome

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What is Quality? The Level of Excellence of a Service

  • Ethical aspects

– Equity – Appropriateness

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What is Quality? The Level of Excellence of a Service

All users have their own preferences Quality is changing and part of a leraning system (history, culture, economy, science)

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Quality Circles

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«Complex» «Complex» (Medical Research Council, 2010)

(Campbell, 2007)

Intervention: QC

  • QCs have numerous and varying

components

  • QCs take place in varying contexts

QCs target different

System: Primary Health Care

Constantly changing:

  • Scientific progress
  • Social and cultural changes
  • QCs target different
  • rganizational levels
  • QCs work is not constant,

develops over time, probably showing a learning curve

  • QCs take place inconsistently
  • ver an uncertain period of time
  • Social and cultural changes

(migration etc.)

  • Economic context
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Philosophies of Knowledge

Positivism Realism Constructivism Positivism Realism Constructivism

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Positivism

There is valid knowledge (truth) only in scientific knowledge: Reports of sensory experience is the exclusive source of all knowledge: empirical evidence

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Constructivism

Constructivists maintain that scientific knowledge is constructed by scientists and not discovered from experiencing and knowledge of the world. Concepts of science are mental constructs proposed in order to explain sensory experience.

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Realism

Realism is regarded as the perspective between positivism and constructivism: it aims to explain knowledge through theories ''what works'' rather ''what works for whom and under what circumstances''

(Pawson, R. 2004, 2005, 2006)

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Realist Interpretation of QCs

  • Causal power lies in the Mechanism
  • Whether the Mechanism is triggered depends on the

Context

  • The Mechanism generates the Outcome!
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How many people do you need to change a light bulb?

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  • It depends on the contex!!!
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Realist Approach

  • Systematic Review:

Aggregation of Data to reveal best solutions

Realist Review:

  • Realist Review:

Comparison of Mechanisms to develop theories explaining the programme

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Research Questions

How do the variations in Quality Circles influence the outcome? How do contextual features improve Quality Circles -individual and/or group performance? and/or group performance? What is the Prevalence of QCs in different states / European countries and how are they organised?

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QCs could improve!

  • Realist comprehensive Review to find the

appropriate contextual features and variations of the programme Validate the results with stakeholders who provided

  • Validate the results with stakeholders who provided

us with theories

  • Test whether adjusted QCs work better

– Before and after studies – Randomized controlled Cluster design

  • Survey in CH / Europe
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HELP

  • Send me local literature
  • Send me local training material

Could you be available for an interview?

  • Could you be available for an interview?
  • If you have an organisation for QC, I would like

to get in touch with you/them!

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adrian.rohrbasser@bluewin.ch

Thank you!!! Thank you!!!