International Journal for Quality in Health Care 6:115-132 (1994)
© 1994 International Society for Quality in Health Care
research-article |
Single and Combined Strategies for Implementing Changes in Primary Care: A Literature Review
Doubts have been raised about the effectiveness of traditional types of continuing medical education. Different strategies or combinations of strategies could prove to be more effective for improving the care provided by the general practitioner. For this reason a systematic literature analysis was carried out involving 75 studies of different strategies applied in primary health care. The strategies most often studied were feedback, reminders and group education. Educational material or group education combined with feedback was the combination most frequently studied. One third of all studies could be characterized as randomized controlled trials. Individual instruction, feedback and reminders seem to be the most effective single strategies. The most effective combined strategies appeared to be all combinations with individual instruction and the combination of peer review and feedback.
Keywords: Quality assurance, physician behaviour
Michel Wensing, Centre for Research on Quality in Family Practice, Nijmegen University, P.O. Box 9101, 6500 HG Nijmegen, The Netherlands.
Received for publication February 1, 1994.
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