1. Copyright © 2006 NHG NHG Practice Accreditation The final (decisive?) step in Quality Improvement in General Practice c.intveld@nhg.org

2. Copyright © 2006 NHG Why? Professionals strive after optimal care for their patients External parties want insight in the quality of the practice organisation and of the medical care given

3. Copyright © 2006 NHG Key Message ‘This practice works systematically and continually on improving the quality of care’

4. Copyright © 2006 NHG But… will it be enough?

5. Copyright © 2006 NHG Questions Which indicators of care can be used for an external review? What are the standards of care and how are they established? Does the quality of care in General Practice really improve?

6. Copyright © 2006 NHG Questions Which indicators of care can be used for an external review? – Accessibility of the practice – Specific qualities of the doctors – Performance indicators on medical process – Performance indicators on medical outcome

7. Copyright © 2006 NHG Characteristics of the NPA Three year cycle Three different domains: – Practice management – Medical performance – Experiences of patients (EUROPEP)

8. Copyright © 2006 NHG Practice Management Infrastructure Practiceteam Information given to the patients

9. Copyright © 2006 NHG Medical performance Chronic diseases: cardiovascular risk management, diabetes, asthma, COPD Preventive care Prescriptions (antibiotics)

10. Copyright © 2006 NHG Patient experience (EUROPEP) Practice facilities Service Information Privacy, punctuality Specific qualities of doctors Communication

11. Copyright © 2006 NHG First year Data collection, analysis Feedback, benchmarking (reference practices) Improvement plans (planning, execution) Audit

12. Copyright © 2006 NHG Feedback Improvementplan Audit feedback POL Announce ment Orientation Audit Accreditation Intake First year

13. Copyright © 2006 NHG Improvement plans Based on feedback report Topics from three domains: – Practice management – Medical performance – Experiences of patients

14. Copyright © 2006 NHG Improvement plans Goals should fulfill SMART criteria: – Specific – Measurable – Appealing – Relevant, realistic – Time-limited

15. Copyright © 2006 NHG Audit Review of the improvement plans Minimum requirements

16. Copyright © 2006 NHG Audit 2nd and 3d year Did the practice succeed? What about the next plan?

17. Copyright © 2006 NHG NHG Practice Accreditation