RCGP Quality Team Development programme: an illuminative evaluation.
BACKGROUND
There is increasing interest in quality initiatives that are locally owned and delivered, team based, multiprofessional, and formative. The Royal College of General Practitioners' Quality Team Development (QTD) programme is one such initiative aimed at developing primary healthcare teams and their services.


OBJECTIVE
To evaluate QTD from the perspective of participants and assessors.


METHODS
UK primary health care.


METHODS
Twelve of 14 practices and all four primary care organisations (PCOs) approached agreed to participate. Thirty four semi-structured interviews were conducted with key stakeholders. The interviews were taped, transcribed, and analysed using the constant comparative method.


RESULTS
The QTD programme appears to be highly valued by participating organisations. Practice based respondents perceived it as acceptable and feasible, and reported positive changes in teamwork and patient services. They valued its formative, participative, and multiprofessional nature, especially the peer review element. PCOs saw QTD as a method of delivering on prevailing national policies on clinical quality and modernization agendas as well as promoting interorganizational collaboration. The main concerns raised were the workload, particularly for assessors, and maintaining the quality of the assessments and the programme.


CONCLUSIONS
This qualitative study suggests positive benefits for participants in the QTD programme. However, such practices are a self-selecting innovative minority. Further research is needed on more typical practices to identify barriers to their participation in QTD or other formative, team based quality improvement programmes.
University of Surrey, Guildford, Surrey GU2 7XH, UK. f.macfarlane@surrey.ac.uk.
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Macfarlane
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Greenhalgh
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Schofield
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Desombre
D001291:Attitude of Health Personnel; D019985:Benchmarking; D003299:Cooperative Behavior; D004739:England; D005194:Family Practice / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008332:Management Quality Circles; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D016730:Program Development; D036301:Qualitative Research; D019035:Rural Health Services / Q000592:standards; D012955:Societies, Medical; D017749:Total Quality Management / Q000379:methods*; D019037:Urban Health Services / Q000592:standards; D014852:Wales