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Facilitating organisational development using a group-based formative assessment and benchmarking method: design and implementation of the International Family Practice Maturity Matrix
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  1. Glyn Elwyn1,
  2. Marie-Jet Bekkers1,
  3. Laura Tapp2,
  4. Adrian Edwards1,
  5. Robert Newcombe1,
  6. Tina Eriksson3,
  7. Jozé Braspenning4,
  8. Christine Kuch5,
  9. Zlata Ozvacic Adzic6,
  10. Olayinka Ayankogbe7,
  11. Tatjana Cvetko8,
  12. Kees in 't Veld9,
  13. Antonis Karotsis10,
  14. Janko Kersnik8,
  15. Luc Lefebvre11,
  16. Ilir Mecini12,
  17. Goranka Petricek6,
  18. Luis Pisco13,
  19. Janecke Thesen14,
  20. José María Turón15,
  21. Edward van Rossen16,
  22. Richard Grol4
  1. 1Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
  2. 2School of Psychology, University of Southampton, Southampton, UK
  3. 3Department of General Practice, Centre of Health and Society, University of Copenhagen, Copenhagen, Denmark
  4. 4Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  5. 5Department for Medical Sociology, University of Cologne, Cologne, Germany
  6. 6Department of Family Medicine, ‘Andrija Stampar’ School of Public Health, Medical School University of Zagreb, Zagreb, Croatia
  7. 7Institute of Child Health & Primary Care, College of Medicine, Lagos, Nigeria
  8. 8Department of Family Practice, Medical Faculty, Ljubljana, Slovenia
  9. 9Netherlands College of General Practitioners, Utrecht, The Netherlands
  10. 10Greek Association of General Practice, Quality Assurance Committee, Athens, Greece
  11. 11Société Scientifique de Médecine Générale (SSMG), Brussels, Belgium
  12. 12Family Medicine Center, Mitrovica, Kosovo
  13. 13Mission for the reform of Primary Health Care, Ministry of Health, Rua Gomes, Freire, Lisbon, Portugal
  14. 14National Centre for Emergency Primary Health Care, Bergen, Norway
  15. 15Grupo Aragonés de Investigación en Atención Primaria, Aragon Health Sciences Institute, Alcañiz, Spain
  16. 16Lessius University College, Department of Applied Psychology, Antwerp, Belgium
  1. Correspondence to Professor Glyn Elwyn, Department of Primary Care and Public Health, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; elwyng{at}cardiff.ac.uk

Abstract

Introduction Well-organised practices deliver higher-quality care. Yet there has been very little effort so far to help primary care organisations achieve higher levels of team performance and to help them identify and prioritise areas where quality improvement efforts should be concentrated. No attempt at all has been made to achieve a method which would be capable of providing comparisons—and the stimulus for further improvement—at an international level.

Methods The development of the International Family Practice Maturity Matrix took place in three phases: (1) selection and refinement of organisational dimensions; (2) development of incremental scales based on a recognised theoretical framework; and (3) testing the feasibility of the approach on an international basis, including generation of an automated web-based benchmarking system.

Results This work has demonstrated the feasibility of developing an organisational assessment tool for primary care organisations that is sufficiently generic to cross international borders and is applicable across a diverse range of health settings, from state-organised systems to insurer-based health economies. It proved possible to introduce this assessment method in 11 countries in Europe and one in Africa, and to generate comparison benchmarks based on the data collected. The evaluation of the assessment process was uniformly positive with the view that the approach efficiently enables the identification of priorities for organisational development and quality improvement at the same time as motivating change by virtue of the group dynamics.

Conclusions We are not aware of any other organisational assessment method for primary care which has been ‘born international,’ and that has involved attention to theory, dimension selection and item refinement. The principal aims were to achieve an organisational assessment which gains added value by using interaction, engagement comparative benchmarks: aims which have been achieved. The next step is to achieve wider implementation and to ensure that those who undertake the assessment method ensure linkages are made to planned investment in organisational development and quality improvement. Knowing the problems is only half the story.

  • Family medicine
  • general practices
  • microsystem
  • organisation
  • quality of care

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Footnotes

  • Funding This study was achieved without external funding by collaboration between Radboud University Nijmegen Medical Centre and Cardiff University. Other Funders: internal.

  • Competing interests The IFPMM instrument is available copyright-free. A licence is required to gain access to other IFPMM resources and the benchmark database, under the administration of Cardiff University on a not-for-profit basis. No author benefits financially from the licensing arrangements.

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