Reactions to the use of evidence-based performance indicators in primary care: a qualitative study

Wilkinson, Emma K., McColl, Alastair, Exworthy, Mark, Roderick, Paul, Smith, Helen, Moore, Michael and Gabbay, John (2000) Reactions to the use of evidence-based performance indicators in primary care: a qualitative study. Quality in Health Care, 9, (3), 166-174. (doi:10.1136/qhc.9.3.166). (PMID:10980077).


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Objectives: To investigate reactions to the
use of evidence-based cardiovascular and
stroke performance indicators within one
primary care group.

Design: Qualitative analysis of semistructured

Setting: Fifteen practices from a primary
care group in southern England.

Participants: Fifty two primary health
care professionals including 29 general
practitioners, 11 practice managers, and
12 practice nurses.

Main outcome measures: Participants’
perceptions towards and actions made in
response to these indicators. The barriers
and facilitators in using these indicators
to change practice.

Results: Barriers to the use of the indicators were their data quality and their technical specifications, including definitions of diseases such as heart failure and the threshold for interventions such as blood pressure control. Nevertheless, the indicators were sufficiently credible to
prompt most of those in primary care teams to reflect on some aspect of their performance. The most common response
was to improve data quality through increased or improved accuracy of recording. There was a lack of a coordinated team approach to decision making. Primary care teams placed little importance on the potential for performance indicators to identify and address inequalities in services between practices. The most common barrier to change was a lack of time and resources to act upon

Conclusion: For the effective implementation of national performance indicators there are many barriers to overcome at individual, practice, and primary care group levels. Additional training and resources are required for improvements in data quality and collection, further education of all members of primary care
teams, and measures to foster organisational
development within practices. Unless these barriers are addressed, performance indicators could initially
increase apparent variation between practices.

Item Type: Article
ISSNs: 0963-8172 (print)
Related URLs:
Keywords: performance indicators, primary care, primary care groups, training
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
ePrint ID: 181675
Date Deposited: 15 Apr 2011 12:44
Last Modified: 27 Mar 2014 19:35

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