IntroductionAlthough health professionals clearly wish to provide best quality care to their patients there is considerable resistance towards quality improvement activities. This paper describes the integration of small-scale practice-based quality improvement projects into a diploma course for general practitioners (GPs). ContextParticipants in the diploma course in therapeutics by distance learning at the Irish College of GPs are required to complete a quality improvement project. A structured 4000 word report on this project is formally assessed, comprising 30% of the total marks for the diploma. MethodologyForty-five GPs completed the diploma in 2001–02 and their projects were reviewed and classified according to the methodology employed, the clinical topics addressed and the outcomes of the projects. ResultsTwenty-two of the 45 (49%) completed practice-based audits, 10 (22%) undertook the development or implementation of a guideline, eight (18%) described organisational change in the delivery of care and the remaining five (11%) addressed a range of topics. Patients were consulted about their knowledge and satisfaction in 15 of the projects. Eight special clinics were established, 10 practice-specific protocols or guidelines were developed and a number of patient information leaflets were produced. Clinical activities were structured in 10 practices. DiscussionThe success of these projects was grounded in the opportunity that participants had to individualise the application of the knowledge gained on the course. They selected their own topic and completed it with support from the distance learning unit. The relevance and value of undertaking the projects was evident from informal feedback, and a number of participants have undertaken second round audits, and have participated in further quality initiatives and subsequent courses by distance learning including quality projects.
AilÃÂ±is ni Riain, Margaret O?Riordan
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