title: Surveyors' perceptions of the impact of accreditation on patient safety in general practice.
abstract: OBJECTIVE
  To explore Australian General Practice Accreditation Limited (AGPAL) surveyors' perceptions of the impact of accreditation on patient safety and to elicit suggestions for improving patient safety in Australian general practices.
  
  
  METHODS
  We conducted semi-structured telephone interviews with a purposive national sample of 10 AGPAL surveyors from 2 July to 14 December 2012. All interviews were audio recorded, transcribed and summarised.
  
  
  RESULTS
  All participants agreed that accreditation has improved general practices' performance in quality and safety. Participants noted specific areas that need further attention, including sufficient evidence for clinical risk management, which half the participants estimated occurs in about 5%-10% of Australian general practices. Tangible evidence of patient safety activities included having a significant incidents register, providing documentation of near misses, slips, lapses or mistakes, and engaging in regular clinical meetings to discuss incidents and how to avoid them in the future. Participants agreed that the accreditation process could be improved through the inclusion of tighter clinical safety indicators and the requirement of verifiable evidence of a working clinical risk management system.
  
  
  CONCLUSIONS
  Accreditation has had a positive role in improving quality and safety in general practice. The inclusion of tighter indicators that require verifiable evidence will be a step forward. The Australian Primary Care Collaboratives (APCC) Program has an opportunity to build on its previous success in general practice quality improvement to further enhance patient safety in general practice.
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC, Australia. amr.abouelnour@flinders.edu.au.
authors.forename: Amr
authors.initials: A
authors.lastname: Abou Elnour
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC, Australia.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Hernan
authors.affiliation: Improvement Foundation Australia, Adelaide, SA, Australia.
authors.forename: Dale
authors.initials: D
authors.lastname: Ford
authors.affiliation: Australian General Practice Accreditation Limited, Brisbane, QLD, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Clark
authors.affiliation: School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fuller
authors.affiliation: Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Johnson
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, VIC, Australia.
authors.forename: James A
authors.initials: JA
authors.lastname: Dunbar
mesh_terms: D000068:Accreditation / Q000458:organization & administration*; D001315:Australia; D058006:General Practice / Q000458:organization & administration*; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D008485:Medical Audit / Q000458:organization & administration*; D061214:Patient Safety; D058996:Quality Improvement / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration