Quality Circles as means of Knowledge Translation in Primary Health Care

Ongoing quality improvement is fundamental to modern family medicine; it is about providing person-centred, safe and effective care, and efficient use of current resources in a fast-changing environment. There are diverse methods, tools and approaches to quality improvement.

Quality Improvement (QI) is an organised and data-guided activity which brings about positive change in the delivery of care; sharing with Knowledge Translation (KT) the desire to increase the prospect of favourable patient outcomes(Straus et al., 2009). Whereas QI affects local problems like perceived inefficient, harmful  or badly-timed  health care, KT deals with generalizable concepts to increase and disseminate knowledge(Ovretveit and Gustafson, 2003). 

In other words, KT is the synthesis, dissemination and exchange of knowledge to provide effective health care, and QI is the process at the local or organisational level where quality issues arise(Davis, 2006).

Knowledge and skills acquired during medical education are insufficient for maintaining an adequate level throughout a professional career. Therefore, continuous development requires continuous medical education (CME)(Ghosh, 2008, Davis et al., 2009)].

CME is a form of education where physicians acquire new knowledge from research and publications. Incorporation of new medical knowledge into the professional role that allows delivery of good-quality patient care is called continuous professional development (CPD) (Nambiar, 2004). CME and CPD are necessary prerequisites for both QI and KT (Czabanowska et al., 2012).

The emphasis of this conference is on Quality Circles (QCs), small groups of 6 to 12 professionals from the same background who meet at regular intervals to consider their standard practice. The focus of discussion is usually a critical evaluation of a key aspect within the multifaceted nature of quality in health care.

QCs are commonly used in primary health care in Europe to consider and improve standard practice over time. They represent a complex social intervention that occurs within a fast-changing system. Numerous controlled trials, reviews and studies have shown small but unpredictable positive effects on behaviour change. Although QCs seem to be effective, stakeholders have difficulties understanding how the results are achieved and in generalising them with confidence(O'Brien et al., 2007, Forsetlund et al., 2009, Baker et al., 2010, Flodgren et al., 2011, Ivers et al., 2012, Baskerville et al., 2012, Dogherty et al., 2010, Zaher and Ratnapalan, 2012).