developing general practice: the role of the apo method eva lena strandberg phd, audit facilitator...

Developing General Practice:The Role of the APO Method

Eva Lena Strandberg Phd, Audit Facilitator

Lund University, Dept. of Clinical Sciences Malmö, Family Medicine, Malmö University Hospital

16th Nordic Congress of General PracticeCopenhagen, Denmark

Eva Lena Strandberg

Overall aim

Eva Lena Strandberg

To explore

• the role of the APO method

• its possibilities in GPs’ development

I. The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care BMC Fam Pract, 2007, 8:8

II. The meaning of quality work from the general practitioner’s perspective BMC Fam Pract, 2006, 7:6

III. Influence of self-registration on audit participants and their non-participating colleagues Scand J Prim Health Care, 2005;23:42-46

IV. Can a holistic view be measured? A pilot study of the use of audit in general practitioners’ decision making Manuscript

Eva Lena Strandberg

Explorer

Eva Lena Strandberg

Methods

Eva Lena Strandberg

Case study methodology

• Exploratory• Descriptive

Eva Lena Strandberg

The APO method

How do we act?1st registration

How should we act?

Follow-up meeting

Did we change?2nd

registration

Need for change?

Guidelines Actions

Holistic view

Eva Lena Strandberg

• Attitude

• Knowledge

• Circumstances

I. Holistic view

Holistic view

Eva Lena Strandberg

• Attitude

• KnowledgeFactual

Tacit

• Circumstances

I. Holistic view

Eva Lena Strandberg

II. Quality development

GPs’ quality work

Influence of self-registration

Eva Lena Strandberg

III. Influence

60

51 52 53 52

66

54 565959

0

10

20

30

40

50

60

70

A. Före B. Omedelbartföre

C. Registrerings-period

D. Omedelbartefter

E. Efter

Deltagare Icke deltagare

Can holistic view be measured?

Eva Lena Strandberg

Based on the developed definition of the concept of holistic view

• develop an APO protocol• test the protocol

IV. Measurig holistic view

Results

Eva Lena Strandberg

Pilot audit:• 8 of 10 GPs registrered• 255 consultations; 153 with

patients from their own list

IV. Measuring holistic view

Summary

Eva Lena Strandberg

• To achieve systematism in work with quality requires harmony between external demands and needs of the profession’s autonomy

• The APO method satisfies the profession’s need for self-determination and reflection

• The APO method has a role in developing general practice in the broad sense

http://www.lu.se/o.o.i.s/12575

Developing General Practice:The Role of the APO Method

Thank you for your attention!

eva-lena.strandberg@med.lu.se