[Networks for improving quality in general medicine].
BACKGROUND
Quality networks are more common in hospitals than in general practice. This study investigates the feasibility of quality networks in general practice, with attention to key factors that may enhance results from continuous quality improvement, such as team leadership, multidisciplinary involvement and optimalising resources.


METHODS
Multidisciplinary teams from six general practices in a Norwegian county met five times during one year for instructions and mutual learning. A doctor, a nurse and laboratory and administrative personnel represented each office. After an introduction to the improvement method, the teams set out to identify and improve a significant problem area in their practices. Between the five meetings the groups were given individual counselling on their improvement projects. The teams were encouraged to evaluate how they organised and managed their improvement efforts.


CONCLUSIONS
All teams achieved substantial improvements of their problem areas, except for one case, where the leader left in the middle of the project. The meetings led to enthusiasm and stimulated multidisciplinary reflection on own practice. The teams also reported several positive generic effects, e.g. improved communication between professions. The continuous self-evaluation of how the improvement projects were organised generated helpful ideas when progress slowed down. The study demonstrates that networks for quality improvement are useful in general practice, and that awareness of management issues can improve the chances of success.
Pedersen
Otto Brun
OB
Institutt for samfunnsmedisinske fag, Universitetet i Bergen, Postboks 7804, 5020 Bergen. otto-bp@online.no
Hovlid
Einar
E
D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000592:standards; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D007857:Leadership; D007858:Learning; D009664:Norway; D010821:Physicians, Family / Q000193:education; D010865:Pilot Projects; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D000078329:Workforce