1. Quality Improvement in Primary/Ambulatory Care: The new Frontier Focus on Patients Piera Poletti CEREF, Padua (Italy)- poletti@ceref.it

2. Context Assessment –internal (history, physical & social environment, culture - values & knowledge, vision, resources & potentials, “real organization”) –external Stakeholders: expectations, priorities

3. What next? Develop a vision: involvement Assess the gap “Fit in” the vision – improvements –roles –responsibilities

4. Environment for improvement Provide resources (knowledge, opportunities to meet, information system, instruments & processes to communicate) –overcome fear of evaluation –learn to know others, different opportunities

5. Environment for improvement Differentiate action Support: formal & informal training, peer, mentor, information.. Recognition Feedback –focus on vision –focus on everyone contribution

6. Involvement Differentiate & Integrate –roles –opportunities –strategies & tools Systematic process

7. Keys Explicit contribution Educate to participate Everyday events as learning opportunities Data

8. Involvement Connect “outside” to impact –institutions –facilities –subjects Visibility

9. Involvement Flexibility “in a frame” Show the results –project –information system

10. Involvement Patient (diary, box for suggestions, focus groups, satisfaction survey, complains procedure) Patients representatives & Volunteers (committees, focus groups, opinions surveys) Community (focus groups, panels, surveys)

11. CREATIVITY: FIND NEW SOLUTIONS INNOVATION: IMPLEMENT THEM Levitt

12. Involvement Value the contribution (feedback, recognition) Triangulate (institution, professionals, patients, community)

13. Implement Include innovation into the organization (new rules and instruments) Take care of the impact outside Visibility and dissemination