The following is a summary of “Strategies that Facilitate the Delivery of Exceptionally Good Patient Care in General Practice: A Qualitative Study with Patients and Primary Care Professionals,” published in the April 2024 issue of Primary Care by O’Malley et al.
In recent years, a paradigm shift towards proactive, strengths-based approaches in enhancing healthcare quality has gained traction, with the positive deviance approach emerging as a promising strategy. This approach is predicated on identifying and learning from individuals or entities consistently achieving exceptional outcomes. Integral to this methodology is discerning the specific strategies, behaviors, tools, and contextual factors employed by these positive deviants. This study aimed to elucidate and compile such strategies, behaviors, processes, and tools utilized to facilitate the delivery of exceptionally high-quality care within general practice settings. Moreover, the study sought to integrate these elements into an established framework for excellence in general practice, namely the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework.
Methodologically, the study conducted a secondary analysis of data gleaned from semi-structured interviews with a purposive sample of 33 participants, including patients, general practitioners, practice nurses, and practice managers. These interviews delved into the core factors and strategies conducive to exceptional care delivery across five primary care system levels: the patient, provider, team, practice, and external environment. Employing a summative content analysis approach, the data underwent inductive analysis to distill the salient strategies underpinning exceptional general practice care. Subsequently, these strategies were abstracted into a novel tier within the IDEAL framework.
This analysis revealed a comprehensive array of 222 factors contributing to delivering exceptional care, spanning specific behaviors, structures, processes, and contextual elements. Notable examples included patients actively providing feedback and personal history to their providers, effective utilization of technology to support care delivery, proactive management of patient flow, and consistent investigation of delays in wait times. Incorporating these concrete and contextual strategies into the IDEAL framework has augmented its practicality and utility in fostering improvement within general practice settings.
The study underscores the imperative of adopting a multi-level system approach to embed these strategies and cultivate an environment conducive to excellence. Furthermore, the refined IDEAL framework should be transformed into a dynamic learning tool to empower general practice teams in measuring, reflecting upon, and enhancing care delivery within their respective practices.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02352-1
