| Author/Editor | Kersnik, Janko | |
| Title | Management of sickness absence: a quality improvement study from Slovenia | |
| Type | članek | |
| Source | Qual Health Care | |
| Vol. and No. | Letnik 8, št. 4 | |
| Publication year | 1999 | |
| Volume | str. 262-5 | |
| Language | eng | |
| Abstract | Problem A need to improve the communication system between general practitioners (GPs) and the national health insurance institutes (NHII) committee of experts for the referral and approval of sickness leave for patients. Design A structured low cost quality improvement method for motivating GPs to change their current practice was developed. Background and setting The study was done in Kranj health district in Slovenia. GPs and members of the committee of experts identified potential problems using a cause and effect diagram. The study period for baseline data collection was from November 1996 to December 1996, and the re-evaluation took place in May 1997. All GPs in Kranj health district (n=78) took part. Data were collected on 443 patients referred by GPs to the NHII committee during the first phase of the study and 590 patients during the re-evaluation phase. Key measures for improvement Reducing the number of cases reported by members of the committee of experts as causing problems after the intervention. Feedback to GPs about the success of the process. Strategies for change A combination of methods was used: posted feedback, a guideline on record keeping, and a guideline, called AID (analysis of incidental deviations from expected service-in Slovene: analiza izjemnih dogodkov), on processing medical documentation. Effects of change An overall drop was observed in the number of cases that caused problems (from 44% to 26%, p<0.001). The most common problem at baseline (19.4% of the problems)was the seventh most common at the re-evaluation, then contributing only 9.2% of total problems (p=0.02). Lessons leaarnt The results support a quality improvement philosophy that empowers owners of the process to be the key resource in managing change, and they show the importance of the inner motivation of those involved.(Abstract truncated at 2000 characters.) | |
| Descriptors | INSURANCE, HEALTH FAMILY PRACTICE SICK LEAVE QUALITY ASSURANCE, HEALTH CARE SLOVENIA MEDICAL RECORDS PROFESSIONAL STAFF COMMITTEES |