title: Trial of the Primary Care Practice Improvement Tool: building organisational performance in Australian general practice and primary health care.
abstract: OBJECTIVE
  To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities.
  
  
  METHODS
  The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts. Part 1 involved staff in Australian primary care practices assessing how they perceived their practice met (or did not meet) each of the 13 PC-PIT elements of high-performing practices, using a 1-5 Likert scale. In Part 2, two external raters conducted an independent practice visit to independently and objectively assess the subjective practice assessment from Part 1 against objective indicators for the 13 elements, using the same 1-5 Likert scale. Concordance between the raters was determined by comparing their ratings. In-depth interviews conducted during the independent practice visits explored practice managers' experiences and perceived support and resource needs to undertake organisational improvement in practice.
  
  
  RESULTS
  Data were available for 34 general practices participating in Part 1. For Part 2, independent practice visits and the inter-rater comparison were conducted for a purposeful sample of 19 of the 34 practices. Overall concordance between the two raters for each of the assessed elements was excellent. Three practice types across a continuum of higher- to lower-scoring practices were identified, with each using the PC-PIT in a unique way. During the in-depth interviews, practice managers identified benefits of having additional QI tools that relate to the PC-PIT elements.
  
  
  CONCLUSIONS
  The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs.
authors.affiliation: Discipline of General Practice, Centre of Research Excellence &ndash; Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD l.crossland1@uq.edu.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Crossland
authors.affiliation: Discipline of General Practice, Centre of Research Excellence &ndash; Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Upham
authors.affiliation: Discipline of General Practice, Centre of Research Excellence &ndash; Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD.
authors.forename: Tina
authors.initials: T
authors.lastname: Janamian
authors.affiliation: School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD.
authors.forename: Victor
authors.initials: V
authors.lastname: Siskind
authors.affiliation: School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD.
authors.forename: Mary
authors.initials: M
authors.lastname: Sheehan
authors.affiliation: Discipline of General Practice, Centre of Research Excellence &ndash; Building Primary Care Quality, Performance and Sustainability via Research Co-Creation, University of Queensland, Brisbane, QLD.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Jackson
mesh_terms: D001315:Australia; D017598:Efficiency, Organizational; D058006:General Practice / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011331:Private Practice; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care