Quality in Primary Care Open Access

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Abstract

Quality assurance through reflective change (QuARC): involving family medicine community-based preceptors in a continuous quality improvement programme

J Graham Swanson

Introduction Quality assurance through medical chart audit is often not done in family practices because the workload involved is large, time commitment long and feedback delayed. A faculty development project was undertaken to encourage practice audits by community-based family medicine preceptors addressing these barriers.Objective To stimulate involvement in and enthusiasm for practice audit through a shared learning experience.Programme Four 15-minute sessions in an academic year served as the platform for group interaction. The faculty development co-ordinator and a group member with expertise in research, serving as facilitator and mentor, formulated the project. The faculty decided on the topic and collected four data items on a convenience sample of patients over a38-week period. Data were collated and feedback was sent weekly. Participation among preceptors was 61% (16/26); data on 739 patients were collected through weekly convenience sampling and data on 1004 patients were collected from full,electronic medical records (EMR)-aided, audits. Group response was enthusiastic with reflection on the process, quality of charting and rates of mammography.Conclusion An enthusiastic mentor and a collaborating group of physicians can perform a practice audit using simple  methodology on a convenience sample of patients.