title: Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.
abstract: BACKGROUND
  The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes.
  
  
  OBJECTIVE
  To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes.
  
  
  METHODS
  Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project.
  
  
  METHODS
  General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes.
  
  
  CONCLUSIONS
  Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.
authors.affiliation: Danish Institute for Health Services Research, Dampfaergevej 27-29, Copenhagen Ø, Denmark. msb@dsi.dk
authors.forename: Martin Sandberg
authors.initials: MS
authors.lastname: Buch
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
authors.forename: Tina
authors.initials: T
authors.lastname: Eriksson
mesh_terms: D003718:Denmark; D058006:General Practice / Q000458:organization & administration / Q000592:standards*; D058005:General Practitioners; D006801:Humans; D007407:Interviews as Topic; D008502:Medical Secretaries; D017146:Models, Organizational; D009818:Office Nursing; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement / Q000592:standards; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards*