A new concept for continuous documentation of quality circle development in ambulatory care: Initial results from an information system in Germany


Objectives- To establish an information system for the documentation of quality circles (peer review groups) and the assessment of their development.

Design- Ongoing prospective study with standardized documentation of quality circle sessions and feedback from January 1995 - July 1996.

Setting- Quality circles in three German regional Associations of Sickness Fund Physicians.

Results- Documentation forms from 491 meetings of 120 different quality circles (QCs) were analysed. The total number of ambulatory care physicians participating in our study was 1608. Most specialities are involved in QCs, with about 10% of all practising physicians currently participating. Over 77.8% of the sessions focused on medical problems. Only a small although gradually increasing number of QCs collected objective data from the daily practice of participating physicians. Deficits identified through implementation of the system led to increased efforts in neglected areas. As a result innovations like new training courses to teach moderators feasible ways of documentation and evalua-tion as well as a nation-wide database of QCs to support contacts between similar groups in Germany were developed.

Conclusion- Standardized data collection is a prerequisite for the accurate description of QC development and for comparisons between different groups or regions and should be combined with a feedback system. It is currently confined to monitoring the process of development, which, however, can serve as the basis for better assessment of the structure and methods of QCs. Further evaluation of the impact of QC-results on the quality of health care must be based on problem-oriented research and is needed to complement our approach.

Implications- Monitoring QI activities such as QCs with regular individual feedback can be an important support mechanism for their implementation and the involvement of health professionals.

Keywords: quality circles/peer review, feedback system, evaluation