Adrian Edwards, Melody Rhydderch, Yvonne Engels, Stephen Campbell, Vlasta Vodopivec‐Jamšek, Martin Marshall, Richard Grol and Glyn Elwyn
The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and…
Abstract
Purpose
The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.
Design/methodology/approach
Using a convenience sample of 153 practices and 11 facilitators based in the UK, Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.
Findings
All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the UK and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.
Originality/value
The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.
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Laura Tapp, Glyn Elwyn, Adrian Edwards, Søren Holm and Tina Eriksson
Quality improvement (QI) processes in family medicine are becoming increasingly complex. Their influence on the organisation of the sector and on the daily work processes is…
Abstract
Purpose
Quality improvement (QI) processes in family medicine are becoming increasingly complex. Their influence on the organisation of the sector and on the daily work processes is profound and increasing. The literature indicates that many ethical issues are arising from QI work. Therefore this paper aims to identify the experiences of professionals involved in planning and performing QI programmes in European family medicine on the ethical implications involved in those processes.
Design/methodology/approach
Four focus groups were carried out with 29 general practitioners (GPs) and administrators of general practice quality work in Europe. Two focus groups comprised EQuiP members and two focus groups comprised attendees to an invitational conference on QI in family medicine held by EQuiP in Barcelona in November 2006.
Findings
Four overarching themes were identified, including implications of using patient data, prioritising QI projects, issues surrounding the ethical approval dilemma and the impact of QI. Each theme was accompanied by an identified solution.
Practical implications
Prioritising is necessary and in doing that GPs should ensure that a variety of work is conducted so that some patient groups are not neglected. Transparency and flexibility on various levels is necessary to avoid harmful consequences of QI in terms of bureaucratisation, increased workload and burnout on part of the GP and harmful effects on the doctor‐patient relationship. There is a need to address the system of approval for national QI programmes and QI projects utilising more sophisticated methodologies.
Originality/value
This study provides data from GPs who are experienced quality improvers across 17 countries. Many ethical issues were identified and it was possible to clearly map the themes and their relationships and to summarise the identified solutions from an international perspective.
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Abstract
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Natural Fats.—It is important to bear in mind that there is an acute shortage of fats throughout the world. Most of the great sources of tropical fats, palm oil, copra and ground…
Abstract
Natural Fats.—It is important to bear in mind that there is an acute shortage of fats throughout the world. Most of the great sources of tropical fats, palm oil, copra and ground nut oil, are still producing much smaller quantities than before the war, partly because a lack of consumer goods makes the natives disinclined to collect raw material, partly because it takes a long time to rebuild a complicated industry and trade that was wrecked in many areas to a large extent by the upheaval of the war. Other sources of raw fats that were available to us before the war have dried up entirely, so far as we are concerned. India no longer exports edible oils. But, even if these sources of fat were as productive now as they were before the war there would still be a big world shortage, so great has become the demand for fats. As I see the problem, the only real solution, although it necessitates taking a very long‐range view, is rapidly to push ahead with the development of ambitious undertakings in the tropical belt of the world, similar in character to the ground‐nut scheme that our Government has had the courage and initiative to launch. The potential productivity of the vast tropical belt is prodigious, if the enormous tasks of dealing with disease, infestation, sanitation, fertilisation and land conservation can be successfully tackled, as I am confident the pioneer experimental attack in East Africa will demonstrate. Such developments will provide not only the fat so greatly needed for human use but enormous quantities of animal feeding stuffs with which to increase the production of bacon, meat, poultry, milk, butter and cheese. But, as I have remarked, this is a long‐range view. It will be asked whether there is any alternative likely to bring about an increase in. the supply of fats during the next two or three years. There is a possibility that there may be a steady, if slow, improvement. The supply of tropical fats will, I think, tend to get a little better as conditions in the producing areas gradually return to what they were before the war, and there is also the hope, perhaps a rather slender one, that food for livestock will not be as restricted in the next year or two as it has been. Production of whale oil is also on the up‐grade. So much, then, for the supply of ordinary natural fats, but, as we should consider every possible approach to the problem, passing reference should be made to other potential sources of supplies. There are two directions in which much exploration has been undertaken. In both the Germans were the pioneers.