[Quality assurance and review in general practice].
Local procedures for quality assurance are needed to provide safe and reliable health care services. Fjellsiden Health Centre has since 1997 developed a system for quality assurance, which includes an annual review of selected quality items. This article presents the basic elements of the system, supplemented by experiences gained from its implementation. A local manual for essential procedures is the basis for the quality system. Other quality assurance activities are weekly practice meetings based on an annual plan for professional updating, including assessment of new guidelines, audits, cross-disciplinary meetings; reviews of "nearly-mistakes", resuscitation training, user surveys, and surveillance of the working environment. Specified routines are available for information safety. Local medication and equipment are regularly reviewed. Lab quality is regulated by a special system. A simple checklist based on locally developed specifications--relevant and vital issues that can be operationalized and assessed in a simple way--is used for annual quality review. The checklist specifications have lead to discussions about what is good enough and why. It has been easy to compile and summarize the data used for the annual review. We have experienced that our dedication to relevance, reality, and flexible format has contributed to giving quality assurance a natural place in a busy general practice office.
Malterud
Kirsti
K
Fjellsiden legesenter, Kalfarveien 31, 5018 Bergen. kirsti.malterud@isf.uib.no
D003151:Community Health Centers / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D006801:Humans; D009664:Norway; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care