Are Differences in Practitioners' Acceptance of a Quality Assurance Intervention Related to Their Performance

OBJECTIVES: The authors assessed whether practitioners' attitudes toward quality assurance after the intervention are related to their performance before and after the intervention. METHODS: A data base was compiled including a survey of practitioners participating in a randomized, controlled trial of externally coordinated quality assurance in 16 practices. The survey evaluated whether practitioners noticed changes in their performance or improvements in care as a result of the external review and whether they preferred internal review or external review that promoted practitioner input and a collegial atmosphere. RESULTS: Practitioners' differences in accepting quality interventions related to quality improvement. A minority of practitioners believed that they had changed their practice or that care had improved in response to quality assurance; these options were not associated with actual performance. Many practitioners approved of internal quality assurance; however, most preferred external review. A few totally disagreed with quality assurance. Greater approval of externally coordinated review was marginally associated with worse baseline performance and significantly associated with better postintervention performance. This relationship was reversed for internal review. CONCLUSIONS: It is commonly perceived that practitioners resent external quality assurance. Our results show the opposite. These findings predict practitioner acceptance for a mode of quality assurance now widely used

Business · Family medicine · Intervention (counseling) · Medical education · Psychological intervention · Quality (philosophy) · Quality assurance · Quality management · Randomized controlled trial · Health Policy Implementation Science · Marketing · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes

• Multiattribute and Single-Attribute Utility Functions for the Health Utilities Index Mark 3 System

  David Feeny, William Furlong et al.•Medical Care•2002

  Incluir item

• Developing a Reliable, Valid, and Feasible Plan for Quality-of-Care Measurement for Cancer

  Katherine L Kahn, Jennifer L Malin et al.•Medical Care•2002

  Incluir item

• Development and Validation of a Grading System for the Quality of Cost-Effectiveness Studies

  Chiun-Fang Chiou, Chiun‐Fang Chiou et al.•Medical Care•2003

  Incluir item

• Quality Improvement Among Primary Care Practitioners

  R Heather Palmer, J Lee Hargraves•Medical Care•1996

  Incluir item

• A Review of Physician Cost-Containment Strategies for Laboratory Testing

  Randolph M Grossman•Medical Care•1983

  Incluir item

• Improving Antibiotic Prescribing in Outpatient Practice

  WAYNE A RAY, Raymond Fink et al.•Medical Care•1985

  Incluir item

• The Ambulatory Care Medical Audit Demonstration Project

  R Heather Palmer, J Lee Hargraves•Medical Care•1996

  Incluir item

• Practice Characteristics and Performance of Primary Care Practitioners

  J Lee Hargraves, R Heather Palmer et al.•Medical Care•1996

  Incluir item

• Quality Assurance in Eight Adult Medicine Group Practices

  R Heather Palmer, Rose Strain et al.•Medical Care•1984

  Incluir item

• A Randomized Controlled Trial of Quality Assurance in Sixteen Ambulatory Care Practices

  R Heather Palmer, Thomas A Louis et al.•Medical Care•1985

  Incluir item

• Performance Quality, Gender, and Professional Role

  Judith A Hall, R Heather Palmer et al.•Medical Care•1990

  Incluir item