title: Seeking quality improvement in primary care in Crete, Greece: the first actions.
abstract: OBJECTIVE
  To implement quality improvement programs and assess the clinical effectiveness within the primary care setting.
  
  
  METHODS
  The introduction of clinical governance teams, the establishment of a patient-based record system, and the dissemination of practice guidelines were included among the efforts made to improve the quality of care. The clinical effectiveness was measured using EUROPEP (European Task Force on Patient Evaluations of General Practice tool) for evaluating patient's opinion and contracts between health authorities and primary care physicians and nurses.
  
  
  RESULTS
  Clinical governance teams of 5-6 practitioners were formed in all health centers. Health cards were created for 6,150 individuals, and a high satisfaction rate with the interest in the patient's personal situation (97.6% of participants assessed it as excellent), physical examination (97.6%), and giving information about symptoms and illness (97.6%) was recorded on the EUROPEP sample. Lack of infrastructure and diagnostic equipment were considered as important barriers in implementing contracts in primary care.
  
  
  CONCLUSIONS
  Primary health care in a rural setting in Crete is engaged in setting up systems for implementing clinical governance and quality programs. The Regional Authorities of Health and Welfare should provide further support.
authors.affiliation: Department of Social and Family Medicine, Crete University School of Medicine, Heraklion, Crete, Greece. lionis@galinos.med.uoc.gr
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.forename: Mariza
authors.initials: M
authors.lastname: Tsiraki
authors.forename: Vassilios
authors.initials: V
authors.lastname: Bardis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Philalithis
mesh_terms: D006115:Greece; D011320:Primary Health Care / Q000592:standards; D017749:Total Quality Management / Q000458:organization & administration*