[Quality circles in German ambulatory care: results of a continuous documentation in the regions of Bremen, Saxony-Anhalt, Schleswig-Holstein and Westphalia-Lippe 1995-2007].
BACKGROUND
Quality circles (QC) are viewed as one of the most important tools of quality improvement and continuing education in ambulatory care. Yet, little is known about the quality of QC work.


METHODS
From 1995 to 2007, an external assessment of QC work took place at four regional Associations of Statutory Health Insurance (SHI) Physicians. After each meeting, QC leaders completed questionnaires. This basic documentation focused on important features of QC work--continuity, topics, methods, results and satisfaction.


RESULTS
28,800 meetings in 1,640 quality circles were documented, and 27,255 documents from 1,241 groups analysed. Continuity was high over long periods, and medical topics were dealt with in more than 80% of the time. The use of appropriate methods, however, have room for improvement. Participants were very satisfied.


CONCLUSIONS
For the first time the quality of QC structures, processes and results was assessed in Germany using a broad dataset. The working principles of QC appear to be well-established. Using the basic documentation practical recommendations are made to improve the quality of QC.
Andres
Edith
E
AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen. edith.andres@aqua-institut.de
Beyer
Martin
M
Schorsch
Birgit
B
Szecsenyi
Joachim
J
Dryden
Wolfgang-Axel
WA
Kreuz
Ingeborg
I
Kunze
Maria-Tatjana
MT
Tischer
Karl-Wilhelm
KW
Gerlach
Ferdinand M
FM
D000553:Ambulatory Care / Q000592:standards*; D004282:Documentation / Q000592:standards; D005858:Germany; D006801:Humans; D008332:Management Quality Circles / Q000592:standards; D012040:Regional Health Planning / Q000592:standards