Subject(s)
Family Practice , Ultrasonography , Clinical Competence , Family Practice/education , Family Practice/standards , Humans , NorwayABSTRACT
Norwegian general practitioners have the opportunity to perform preventive medicine on many levels. There are uncertainties as to the effect of this activity. A systematic approach is one of the prerequisites for obtaining significant results. We have made a study of the review literature concerning computerised patient-specific reminders used in preventive health care. Electronic literature search was supplemented by expert-guided manual search. We found that a conclusion from the literature is that such computerised reminders have a lasting effect regarding doctors' handling of preventive care issues. The effect of reminders in a general practice setting will be determined by the way they are implemented. In this process it will be necessary to address motivating issues, technical solutions and administrative adjustments.
Subject(s)
Decision Making, Computer-Assisted , Family Practice , Medical Records Systems, Computerized , Preventive Health Services , Humans , Norway , Referral and ConsultationABSTRACT
Between 1995 and 1998 the Norwegian Medical Association carried out a project to develop and assess a quality improvement tool for use in general practice (SATS). This method combines self-directed learning, documentation of practice and peer group support. SATS defined performance indicators for registration of practice by means of computerised patient records. Groups of four to ten general practitioners used their own consultation data as a basis for learning cycles. The practice evaluation indicates significant improvement in clinical work. Participating doctors found that having their own recorded data examined in a supportive peer environment was a major force for change. They reported satisfaction with the method, and expressed an interest in trying out new topics. However, the project demonstrated the need for simplification of terminology, further development of group process methods and computer software. There is also a need for strong local support of peer review groups.
Subject(s)
Clinical Competence , Education, Medical, Continuing , Family Practice/standards , Learning , Quality Assurance, Health Care , Education, Medical, Continuing/methods , Family Practice/education , Humans , Medical Records Systems, Computerized , Norway , Peer Review, Health Care , Quality Indicators, Health Care , Referral and Consultation/standards , Self EfficacyABSTRACT
General practitioners (GPs) in Norway are in a unique position to influence their patients' lifestyles during consultations. The specialty of family medicine has been recognized in Norway since 1985. In continuing medical education, nutrition issues are integrated with the discussion of relevant diseases. The first book on health education for Norwegian general practice (1990) contains a set of general dietary guidelines. GPs are informed of the results of the National Health Screening Service, which measures blood pressure and serum lipids and records smoking habits. Serum cholesterol concentrations and coronary artery disease mortality are declining. GPs have been involved in this achievement, although they were found in 1988 to set more conservative cutoffs of serum cholesterol concentrations for dietary advice than an expert committee. GPs have been directly involved in preparing the latest cholesterol guidelines. In 1994 Norwegian GP organizations started a project of quality indicators in general practice (SATS). Of the four conditions that are themes for the first project, treatment of diabetes mellitus has a major nutritional aspect.
Subject(s)
Counseling , Family Practice , Nutritional Sciences/education , Physician's Role , Adult , Counseling/standards , Family Practice/standards , Family Practice/trends , Female , Humans , Male , Middle Aged , Myocardial Ischemia/mortality , Myocardial Ischemia/prevention & control , Norway/epidemiology , Practice Guidelines as Topic , Quality Control , Time FactorsSubject(s)
Child Health Services , Family Practice , Parents , Adult , Child , Humans , Norway , Surveys and QuestionnairesABSTRACT
Research is a prerequisition for setting standards in the field of quality assurance. It is emphasized that scientific work that is intended to have an impact on general practice has to be carried out in general practice. Quality assurance plays a decisive role in recognizing and applying the results of relevant research. The author discusses the significance of typical topics concerning the presentation and prevalence of diseases in general practice. Issues related to quality assurance of scientific studies performed by general practitioners are considered. Intra- and interobserver variation as a problem towards achieving reliable results is described and discussed. The author emphasises the importance of The research council in general practice, as a help in achieving quality assurance.
