title: Developing a framework of, and quality indicators for, general practice management in Europe.
abstract: OBJECTIVE
  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%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, 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.
authors.affiliation: Centre for Quality in Care Research (WOK), Nijmegen, The Netherlands. y.engels@kwazo.umcn.nl
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
authors.forename: Stephen
authors.initials: S
authors.lastname: Campbell
authors.forename: Maaike
authors.initials: M
authors.lastname: Dautzenberg
authors.forename: Pieter
authors.initials: P
authors.lastname: van den Hombergh
authors.forename: Henrik
authors.initials: H
authors.lastname: Brinkmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Szécsényi
authors.forename: Hector
authors.initials: H
authors.lastname: Falcoff
authors.forename: Luc
authors.initials: L
authors.lastname: Seuntjens
authors.forename: Beat
authors.initials: B
authors.lastname: Kuenzi
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: D003697:Delphi Technique; D005060:Europe; D006801:Humans; D011216:Practice Management, Medical / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care / Q000592:standards*; D011795:Surveys and Questionnaires