Quality improvement in multi-professional primary health care units: Lessons learned from Austria

Abstract

Abstract Issue/problem In 2017, Austria started the establishment of multi-professional primary health care units (PCUs) to better meet patients’ and healthcare professionals’ needs including a focus on health promotion, health literacy and patients with chronic diseases. Currently, Austria has 40 operational PCUs. In the province of Styria, the quality of care in PCUs is monitored through quality indicators (QI) in annual surveys. The patient questionnaire includes items on patient satisfaction, shared decision-making, and self-management. The PCU team questionnaire covers organizational routines and working satisfaction. Description of the problem Only few improvement initiatives were launched in response to the QI surveys, especially for low-performing QI. In addition, the concept of quality indicators seemed difficult for the teams to understand. As a result, from 2021 on, the surveys are being conducted every other year. In the intervening years, PCU teams get the opportunity to discuss and reflect on the previous yeaŕs results in facilitated workshops. Results We held workshops in the ten PCUs in Styria from October 2022 to February 2023. In the workshops, the teams identified six strengths (e.g. providing a wide range of services) and six weaknesses (e.g. appointment coordination) of the PCUs with corresponding actions for improvement (e.g. managing the patient flow). Lessons Combining the QI surveys with workshops lead to practical actions for quality improvement as well as a better understanding of the relevance of quality indicators among PCU teams and funders. Workshops provided the teams with a dedicated space for reflecting on organizational processes, which they may not have the opportunity to do amidst their heavy workload and still adjusting to PCU structures. Key messages • Engaging the PCU teams in the quality improvement process ensures that the resulting actions are more relevant to their needs and priorities. • Our quality indicators as well as the identified actions for quality improvement are highly transferable to other primary care settings and countries.