Introducing a quality improvement programme to primary healthcare teams

Objectives-To evaluate a programme in which quality improvement was facilit ated, based on principles of total quality management, in primary healthcar e teams, and to determine its feasibility, acceptability, effectiveness, an d the duration of its effect. Method-Primary healthcare teams in Leicestershire (n=147) were invited to t ake part in the facilitated programme. The programme comprised seven team m eetings, led by a researcher, plus up to two facilitated meetings of qualit y improvement subgroups, appointed by each team to consider specific qualit y issues. Outcome measures-To assess the effect and feasibility of the programme on i mproving the quality of care provided, the individual quality improvement p rojects undertaken by the teams were documented and opportunities for impro vement were noted at each session by the facilitator. The programme's accep tability was assessed with questionnaires issued in the final session to ea ch participant. To assess the long term impact on teams, interviews with te am members were conducted 3 years after the programme ended. Results-10 of the 27 teams that initially expressed interest in the program me agreed to take part, and six started the programme. Of these, five compl eted their quality improvement projects and used several different quality tools, and three completed all seven sessions of the programme. The program me was assessed as appropriate and acceptable by the participants. Three ye ars later, the changes made during the programme were still in place in thr ee of the six teams. Four teams had decided to undertake the local quality monitoring programme, resourced and supported by the Health Authority. Conclusions-The facilitated programme was feasible, acceptable, and effecti ve for a few primary healthcare teams. The outcomes of the programme can be sustained. Research is needed on the characteristics of teams likely to be successful in the introduction and maintenance of quality improvement prog rammes.