EPA: EUROPEAN Hone Appraisal.


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EPA: EUROPEAN Hone Evaluation Analyst: Yvonne Engels Venture pioneer: Richard Grol Co-ordinator: Maaike Dautzenberg Financed by: Bertelsmann establishment Germany Cooperation Belgium (Flanders), France, Germany, Switzerland, the Netherlands, UK (Wales and Britain)
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EPA: EUROPEAN PRACTICE ASSESSMENT Researcher: Yvonne Engels Project pioneer: Richard Grol Co-ordinator: Maaike Dautzenberg Financed by: Bertelsmann establishment Germany

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Collaboration Belgium (Flanders), France, Germany, Switzerland, the Netherlands, UK (Wales and England) Bertelsmann Foundation

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Aim to add to a practice evaluation strategy that helps family/general professionals in enhancing their practice execution

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Methods: Literature audit Workshops with accomplices Consensus techniques - with EPA-accomplices - Delphi Pilot

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Good practice administration: “Systems (structures and procedures) intended to empower the conveyance of good quality patient care”

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Framework Infrastructure Staff Information Finance Quality and wellbeing

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170 pointers, e.g.: Domain: INFRASTRUCTURE Dimension: medical hardware Indicator: The crisis sack is complete

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Modified Rand system 170 markers Translation of the draft set of markers Delphi methodology Rated by 10 GPs/specialists in 6 nations

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Indicators appraised ‘useful’ (of 168) By all countries 62 (37%) France 103 (61%) Germany 103 (61%) Swiss 116 (69%) Belgium 121 (72%) Netherlands 125 (74%) England/Wales 142 (85%)

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Exercise 1 Which markers do you rate valuable? (gatherings of around 6 persons, ideally from distinctive nations

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A. Data for patients about clinical consideration: 0 An up and coming choice of books and features is accessible to patients A scope of handouts and pamphlets is accessible for patients to peruse in the practice or to take home Translator administrations are accessible on solicitation Information flyers are accessible in suitable dialects The practice data sheet is accessible in fitting dialects

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B. Non-medicinal gear: 4 The practice has an operational fax The practice has no less than one PC for staff The practice has a web association All PCs are secured against improper get to Every GP has entry to email Every GP has admittance to the web (www) The practice has a phone framework with adequate internal and outward limit The practice has a different crisis phone line All electronical restorative hardware is checked yearly All wellbeing gear (e.g. fire quencher) is checked yearly

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C. Recognition of value and security issues: 0 The practice has embraced no less than one clinical review in the most recent year The practice has a discriminating occurrence enroll The practice has a recorded procedure to catch up and examine basic episodes The practice has a formal meeting procedure with patients (persistent discussion or cooperation assemble) The practice has a proposal box for patients The practice has a composed patient grievance methodology The composed patient dissension system is accessible at the gathering

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D. Working conditions: 2 The practice screens the workload of its staff The practice screens anxiety levels of its staff The practice assesses group working in the association The practice has had no less than one away day a year ago Staff encounter a wonderful working air The practice has an approach which empowers staff to offer recommendations for enhancing practice administration The practice has composed courses of action to guarantee the accessibility of a locum GP when required

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The Instrument Short self-directed surveys: Representative of the practice individual GPs staff individuals Patients Observer/facilitator visits the practice: Structured meeting with GP/PM Checklist ( Maturity Matrix )

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The pilot Pretest in 3 rehearses per nation September 2003-May 2004: Pilot in 30 hones for every nation , likewise in Slovenia, Austria and Israel

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Result of the pilot Feedback on individual practice level National information International examinations.

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Visotool/Startbildschirm

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Online-Feedback Basisdaten der Praxis (insgesamt 4 Bildschirmseiten)

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Ergebnisse/Dimensionen (Bsp. Infrastruktur: Übersicht )

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Ergebnisse/Dimensionen (Bsp. Infrastruktur: Streudiagramm )

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schedule (illustration)

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Patient cooperation (%) complaint strategy Belgium 3 France 3 Germany 25 Netherlands 75 Switzerland 25 UK 100 Slovenia 77 Austria 55

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Survey quiet fulfillment (%) (n) Belgium (31) 23 France (17) 3 Germany (32) 39 Netherlands (32) 38 Switzerland (28) 64 UK (27) 85 Slovenia (31) 53 Austria (33) 24

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Europep GP Practice Belgium (31) 91 85 France (17) 85 72 Germany (32) 84 83 Netherlands (32) 85 72 Switzerland (28) 91 90 UK (27) 81 69 Slovenia (31) 90 87 Austria (33) 93 91

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Leaflets (%) pract. inf. Belgium 41 France 42 Germany 55 Netherlands 88 Switzerland 48 England 87 Slovenia 48 Austria 27

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Medical enrollment ICPC and so forth Belgium 52 France 24 Germany 100 Netherlands 87 Switzerland 29 UK 100 Slovenia 100 Austria 12

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Patient rundown (%) Belgium (31) 81 France (29) 0 Germany (32) 0 Netherlands (32) 100 Switzerland (28) 74 UK (27) 100 Slovenia (31) 100 Austria (33) 0

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System for reviewing patients with: Asthma Diabetes CHD Belgium 65 42 32 France 0 0 Germany 22 47 28 Netherlands 62 91 50 Switzerland 14 32 21 UK 96 100 96 Slovenia 16 35 32 Austria 12 24 12

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System for reviewing populaces at danger: CHD Influenza vacc Belgium 16 42 France 0 0 Germany 16 41 Netherlands 56 100 Switzerland 7 68 UK 74 96 Slovenia 97 68 Austria 0 0

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Exercise 2 Discuss in little gatherings: Do general practices in your nation have frameworks to review patients with particular perpetual sicknesses? Why (not)? Populaces at danger? Why (not)?

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What next? Approval of the instrument: (worthy, doable, substantial, touchy) Adapted rendition: one year from now International information stockroom

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EPA-book: January 2005 y.engels@wok.umcn.nl www.wokresearch.nl www.aqua-institut.de (data Visotool)

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