Use of quality circles for primary care providers in 24 European countries: an online survey of European Society for Quality and Safety in family practice delegates

Abstract

Objective: To identify and describe the core characteristics and the spread of quality circles in primary healthcare in European countries.

Design: An online survey was conducted among European Society for Quality and Safety in Family Practice (EQuiP) delegates. To allow comparison with earlier results, a similar survey as in a study from 2000 was used.

Setting: Primary Health Care in European countries.

Subjects: General practitioners, delegated experts of the European Society for Quality and Safety in Family Practice (EQuiP).

Main outcome measures: (1) Attendance in quality circles (2) their objectives (3) methods of quality improvement quality circles use (4) facilitator’s role and training (5) role of institutions (6) supporting material and data sources quality circles use.

Results: 76% of the delegates responded, representing 24 of 25 countries. In 13 countries, more than 10% of general practitioners participated in quality circles, compared with eight countries in 2000. The focus of quality circles moved from continuous medical education to quality improvement. Currently, quality circles groups use case-based discussions, educational materials and local opinion leaders in addition to audit and feedback. Some national institutions provide training for facilitators and data support for quality circle groups.

Conclusion: The use of quality circles has increased in European countries with a shift in focus from continuous medical education to quality improvement. Well-trained facilitators are important, as is the use of varying didactic methods and quality improvement tools. Qualitative inquiry is necessary to examine why QCs thrive or fail in different countries and systems.

KEY POINTS

• Countries with already established quality circle movements increased their participation rate and extended their range of quality circle activities

• The focus of quality circles has moved from CME/CPD to quality improvement

• Well-trained facilitators are important, as is the use of varying didactic methods and quality improvement tools

• Institutions should provide supporting material and training for facilitators

Acknowledgements

Members of the EQuiP Working Group on Quality Circles contributed with critical input to the methods and analysis of the results. We thank Kali Tal, Institute of Primary Health Care (BIHAM), University of Bern, Switzerland, for her editorial suggestions.

Ethics approval

The Swiss ethics committee classed involvement with QCs as service evaluation with no need for ethical approval. As the study results contribute to a PhD project at the University of Oxford, the project went through the Central University Research Ethics Committee’s application process in Oxford and was approved (MSD-IDREC-C1-2015-002). This study fulfilled the requirements of informed consent, handling of personal information and confidentiality according to operational principles of the Declaration of Helsinski and adheres to the Belmont Report principles concerning respect for persons, beneficence and justice.

Disclosure statement

No potential conflict of interest was reported by the authors.