Organizational assessment in general practice: a systematic review and implications for quality improvement.
BACKGROUND
Quality improvement of organizational aspects in general practice is receiving increasing attention. In particular, the impact of effective organization on preventative care has been recognized. Organizational assessments are typically used as part of professionally led accreditation schemes where there is a tension between externally led quality assurance and internally led quality improvement. The aim of this article is to inform the debate by reviewing the international-peer-reviewed literature on organizational assessments used in general practice settings.


METHODS
Systematic literature review.


METHODS
The literature was searched for articles relating to organizational assessment. Titles and abstracts were examined by two independent reviewers and relevant articles obtained. Bibliographies were examined for follow-up references. Data were extracted on the development and use of assessment methods.


RESULTS
Thirteen papers describing five organizational assessment instruments were included for detailed appraisal.


CONCLUSIONS
This review discovered a developing field containing different approaches to the measurement of organizational aspects of general practice. Whilst professionally led accreditation is well-developed and dependent on externally led quality assurance, approaches to internally led quality improvement are less well-developed. There is a need for organizational assessment tools designed for the purpose of stimulating internal development.
Rhydderch
Melody
M
Organisational Psychologist, Primary Care Group, University of Wales Swansea, Swansea SA2 8PP, UK. m.rhydderch@swansea.ac.uk
Edwards
Adrian
A
Elwyn
Glyn
G
Marshall
Martin
M
Engels
Yvonne
Y
Van den Hombergh
Pieter
P
Grol
Richard
R
D005194:Family Practice / Q000458:organization & administration*; D013222:State Medicine; D017749:Total Quality Management; D006113:United Kingdom