Decentralized diagnostics of beta haemolytic streptococci group A--introduction of a developmental model for microbiological consultation in primary health care.
OBJECTIVE
To define and evaluate forms for introduction of decentralized diagnosis in primary care.


METHODS
The study was divided into three phases. Intervention I. An intensive course on microbiological diagnostics in cases of tonsillitis with information about rapid EIA-based test kits for beta haemolytic streptococci group A. Intervention II. External quality assurance of the decentralized test. Evaluation. Recording of changes in work practice and attitude regarding decentralized diagnosis by means of a questionnaire.


METHODS
Thirty-three GPs and 36 laboratory technicians from 37 primary health care centres (PHC) in the county of Ostergötland, Sweden.


RESULTS
Thirty-one of the responding GPs (94%) considered that the information gained from quality assurance was useful. Twenty-nine GPs (88%) reported that they had changed their clinical practice to some extent, and 26 of the responding laboratory technicians (72%) reported that they had changed method after the interventions.


CONCLUSIONS
Uniform acceptance was not achieved, but a large number of GPs and PHC laboratory technicians did conform to a rational-empirical strategy for change in clinical practice.
D005194:Family Practice / Q000193:education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D017056:Medical Laboratory Personnel / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D017146:Models, Organizational; D010821:Physicians, Family / Q000193:education / Q000523:psychology; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000458:organization & administration*; D013290:Streptococcal Infections / Q000382:microbiology*; D013297:Streptococcus pyogenes; D011795:Surveys and Questionnaires; D014069:Tonsillitis / Q000382:microbiology*