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Background: A systematic review has shown that no measures of the extent to which healthcare professionals involve patients in decisions within clinical consultations exist, despite the increasing interest in the [...]

Background: A study was undertaken to determine the effectiveness of asthma self-management in general practice. Methods: Nineteen general practices were randomly allocated to usual care (UC) or self-management (SM). Asthma [...]

Objectives: To compare patients' and general practitioners' (GPs') evaluations of the quality of general practice care. Design: Written surveys among patients and GPs. Setting: General practice in the Netherlands. Subjects: [...]

Objective: To assess the appropriateness of and variation in intention-to-treat decisions in the management of depression in the Netherlands. Design: Mailed survey with 22 paper cases (vignettes) based on a [...]

Abstract Objective--To assess the effects of feedback of patients' evaluations of care to general practitioners. Design--Randomised trial. Setting--General practice in the Netherlands. Subjects--55 GPs and samples of 3691 and 3595 [...]

Expectations of healthcare services are ever increasing and those delivering care no longer hold the monopoly of opinion on what constitutes good or best care. To earn the label 'good [...]

Peer review groups (PRGs) and quality circles (QCs) commenced in The Netherlands and have grown to become an important method of quality improvement in primary care in several other European countries.

The aim of this study was to investigate the feasibility of systematic monitoring of patients' quality of life and its relationship to GPs' interventions concerning management of asthma and chronic obstructive pulmonary disease (COPD).

Continuous quality improvement (CQI) offers opportunities to improve care in small-scale office-based practice. Little is yet known about the implementation of CQI in small primary care practices. We studied the attitudes of physicians and staff in small family practices to a model of CQI tailored to office-based practice setting. PRACTICES AND DESIGN: An exploratory study in 20 family practices in The Netherlands. Practices were stimulated to adopt the model for continuous quality improvement.

To evaluate the applicability of the Dutch dementia guideline's recommendations, including the diagnostic criteria used by family practitioners, and to explore characteristics in both patients and family practitioners which are associated with the use of these recommendations.

There is an increasing number of studies showing that patients often do not receive necessary care or receive care that is not needed, inefficient or even damaging. There is no lack of ideas and approaches on how to improve practice. In the last decades we have seen the rise of fascinating models for quality improvement, for instance Evidence Based Medicine, Total Quality Management and Patient Partnership. These models are interesting and potentially very valuable in improving patient care. However, the evidence for their (cost-) effectiveness is very limited. The challenge for the years to come is to design strategies for quality improvement that integrate elements from the different models and to set the step from anecdotal evidence for these strategies to systematic evaluation in order to distinguish between faith and fact in the field of improving care.

To assess patients' views on the organization of (cardiovascular) preventive care.

Although patients' views on health care are perceived to be crucial, insight into the different constructs capturing these views remains limited.

To evaluate and compare the effects of two programmes of assessment of practice management in a practice visit: mutual visits and feedback by peers compared with visits and feedback by non-physician observers.

To evaluate the feasibility and acceptance of (a) two programmes of assessment of practice management in a practice visit: mutual practice visits and feedback by peers versus visits and feedback by non-physician observers and (2) the practice visit method used in these programmes (the visit instrument to assess practice management and organisation (VIP)--a validated Dutch tool).

To study the effectiveness of an intensive small group education and peer review programme aimed at implementing national guidelines on asthma/chronic obstructive pulmonary disease (COPD) on care provision by general practitioners (GPs) and on patient outcomes.

To evaluate the feasibility of a model for continuous quality improvement in small scale general practice and the improvement projects that practices ran after the introduction of continuous quality improvement.

Improving the sensitivity of general practice to patients' needs demands a good understanding of patients' expectations and priorities in care provision. Insight into differences in expectations of patients in different cultures and health care systems may support decision-making on desirable models for care provision in general practice. An international study was conducted to determine priorities of patients in general practice care: which views do patients in different countries have in common and which views differ?

To assess the effects of a Dutch national prevention programme, aimed at general practitioners (GPs), on the adherence to organizational guidelines for effective cervical cancer screening in general practice. To identify the characteristics of general practices determining success.

To evaluate the feasibility and implementation needs of a cholesterol guideline by assessing the effectiveness of simple dissemination as well as extensive implementation of this guideline on actual performance of general practitioners (GPs).

Self-management of asthma is becoming more and more widespread. The implementation of this treatment strategy requires changes in the role and attitude of the GP. These changes may be hindered by obstacles both expected and experienced. As self-treatment of asthma is more common in the UK, comparison between UK and Dutch GPs provides a good opportunity to identify possible obstacles in general practice to the implementation of self-treatment of asthma with inhaled corticosteroids.

In 1989 a Dutch national guideline on (imminent) miscarriage was developed for use in general practice. A prospective recording study was carried out to determine how the patients evaluated the care they received from general practitioners (GPs) and midwives who agreed to adhere to this (imminent) miscarriage guideline and to determine the aspects that influence this evaluation.

To gain insight into processes of dissemination of clinical guidelines, sources of information physicians use to become informed about them, and factors influencing these processes.

Authors of successful outreach visit studies stress the importance of tailoring the intervention to the unique attributes and needs of each practice. For a better understanding of the outreach visit method, the tailoring mechanism is explored in this article. The variation among practices in preventive outreach visits to implement guidelines and characteristics that determine the variation (baseline adherence to organizational guidelines, practice and visitor characteristics) are described. We explored whether and how many visits were paid to practices that showed no increase in adherence to guidelines.

To determine the feasibility for midwives to adhere to Dutch national guidelines on threatened miscarriage in general practice.

To estimate the number of questions and patients that are needed to achieve reliable measurements of patients' judgements of care in general practice.

To assess the effects of outreach visits by trained nurse facilitators on the organisation of services used to prevent cardiovascular disease. To identify the characteristics of general practices that determined success.

To compare the profiles of those patients selected by general practitioners for measurement of serum cholesterol with the recommended profiles for opportunistic cholesterol testing described in the national practice guidelines published by the Dutch College of General Practitioners.

To develop a list of indicators of the general practice care of people with chronic illnesses considered important by both patients and practitioners and to identify the indicators that are considered relevant for patient assessment of health care quality.

The main aim of this study was to reach consensus between students, faculty and general practice teachers on the educational objectives and requirements of the clerkship in general practice.

Well-organized cervical screening has been shown to be effective in the reduction of both morbidity and mortality from cancer of the uterine cervix. In The Netherlands, the GP plays an important role in the cervical screening. The question is whether the general practices are able to organize an effective cervical cancer screening.

The precise relationship between practice management (structure) and the doctor's actual performance (process) in general practice is tenuous. Analysis of their mutual relationship may yield insight into the way they contribute to outcome and into corresponding assessment procedures.