Effects of a nationwide programme: interventions to reduce perceived barriers to collaboration and to increase structural one-on-one contact.
OBJECTIVE
To describe the implementation of a nationwide programme and to determine the effects of specific quality improvement (QI) interventions within this programme on perceived barriers to collaboration between general practitioner (GPs) and mental health professionals and frequency of structural one-on-one contact regarding individual patients.


METHODS
The implementation of regional QI-interventions, perceived barriers to collaboration, and frequency of structural one-on-one contact, were assessed in a cohort study involving two surveys (2001 and 2003) among a random sample of 2757 GPs.


RESULTS
1336 and 1358 GPs returned baseline and follow-up questionnaires respectively. Most of the interventions were only offered to a minority of GPs. Less than 25% of GPs that had been offered interventions actually participated. The frequency of structural one-on-one contact with mental health professionals did not change, but barriers to collaboration decreased between 2001 and 2003. For GPs who actually participated in interactive small group meetings or in intervention in which mental health professionals were integrated in general practice, a reduction of perceived barriers could be observed as well as an increase in the frequency of structural one-on-one contact.


CONCLUSIONS
Interventions that could be characterized as interactive small group meetings as well as interventions that involved the integration of mental health professionals in general practice led to a reduction of perceived barriers as well as an increase in the frequency of structural one-on-one contact. These findings add to the knowledge of which interventions have an effect on the collaboration between different health care providers.
Heideman
Jantien
J
Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, The Netherlands. j.heideman@kwazo.umcn.nl
Laurant
Miranda
M
Verhaak
Peter
P
Wensing
Michel
M
Grol
Richard
R
D000328:Adult; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D003142:Communication; D019033:Delivery of Health Care, Integrated; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration / Q000592:standards; D009426:Netherlands; D010348:Patient Care Team; D010821:Physicians, Family; D011320:Primary Health Care; D011570:Psychiatry; D011584:Psychology; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D012041:Regional Medical Programs / Q000458:organization & administration / Q000592:standards; D012949:Social Work, Psychiatric