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Documenting organisational development in general practice using a group-based assessment method: the Maturity Matrix
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  1. Tina Eriksson1,
  2. Volkert Dirk Siersma2,
  3. Louise Løgstrup1,
  4. Martin Sandberg Buch3,
  5. Glyn Elwyn4,
  6. Adrian Edwards4
  1. 1Department of General Practice, Centre of Health and Society, University of Copenhagen, Copenhagen, Denmark
  2. 2Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3Danish Institute for Health Services Research, Copenhagen, Denmark
  4. 4Department of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, UK
  1. Correspondence to Dr Tina Eriksson, Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Munkegårdsvej 41b, 3490 Kvistgård, Denmark; eriksson{at}dadlnet.dk

Abstract

Objective The Maturity Matrix (MM) comprises a formative evaluation instrument for primary care practices to self-assess their degree of organisational development in a group setting, guided by an external facilitator. The practice teams discuss organisational development, score their own performance and set improvement goals for the following year. The objective of this project was to introduce a translated and culturally adapted version of the MM in Denmark, to test its feasibility, to promote and document organisational change in general practices and to analyse associations between the recorded change(s) and structural factors in practices and the factors associated with the MM process.

Setting MM was used by general practices in three counties in Denmark, in two assessment sessions 1 year apart. First rounds of MM visits were carried out in 2006–2007 in 60 practice teams (320 participants (163 GPs, 157 staff)) and the second round in 2007–2008. A total of 48 practice teams (228 participants (117 GPs; 111 staff) participated in both sessions.

Method The MM sessions were the primary intervention. Moreover, in about half of the practices, the facilitator reminded practice teams of their goals by sending them the written report of the initial session and contacted the practices regularly by telephone reminding them of the goals they had set. Those practice teams had password-protected access to their own and benchmark data.

Results Where the minimum possible is 0 and maximum possible is 8, the mean overall MM score increased from 4.4 to 5.3 (difference=0.9, 95%, CI 0.76 to 1.06) from first to second sessions, indicating that development had taken place as measured by this group-based self-evaluation method. There was some evidence that lower-scoring dimensions were prioritised and more limited evidence that the prioritisation and interventions between meetings were helpful to achieve changes.

Conclusions This study provides evidence that MM worked well in general practices in Denmark. Practice teams appeared to be learning about the process, directing their efforts more efficiently after a year's experience of the project. This experience also informs the further improvement of the facilitation and follow-up components of the intervention.

  • Communication
  • continuous quality improvement
  • family medicine
  • management
  • organisation

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Footnotes

  • Funding The Danish Maturity Matrix project was financed by county/regional public means for quality improvement in primary care.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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