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Family Practice Advance Access published online on February 18, 2005
Family Practice, doi:10.1093/fampra/cmi002
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© The Author (2005). Published by Oxford University Press. All rights reserved.
Received July 15, 2004
Accepted December 30, 2004

Article

Developing a framework of, and quality indicators for, general practice management in Europe

Yvonne Engels 1*, Stephen Campbell 2, Maaike Dautzenberg 1, Pieter van den Hombergh 1, Henrik Brinkmann 3, Joachim Szécsényi 3, Hector Falcoff 3, Luc Seuntjens 3, Beat Kuenzi 3, and Richard Grol 1

1 Centre for Quality in Care Research (WOK), Nijmegen the Netherlands; For the EPA working party (see Appendix 1)
2 For the EPA working party (see Appendix 1); National Primary Care Research and Development Centre, University of Manchester, UK
3 For the EPA working party (see Appendix 1)

* To whom correspondence should be addressed.
Yvonne Engels, E-mail: y.engels{at}kwazo.umcn.nl


  Abstract

Objectives. To develop a framework for general practice management made up of quality indicators shared by six European countries.

Methods. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries.

Results. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixtytwo indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessiblility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels.

Conclusions. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

Keywords: Delphi Technique; Europe; practice management; primary care; quality indicators.
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