Continuous quality improvement using a practice improvement model

摘要

Purpose - Cape and Barkham's practice improvement model (PIM) describes how healthcare systems can be designed to facilitate the usage of self-generated clinical outcomes in the delivery of subsequent interventions. This article aims to describe the application of the PIM in the implementation of group-based cognitive-behavioural therapy, for clients referred from Primary Care with anxiety disorders. Design/methodology/approach - The groups were evaluated using and pre- and post-intervention design using a variety of validated measures of psychological functioning as part of a wider audit and evaluation system. The conclusions drawn from the audit and evaluation system, in the form of PIMs, were fed-back into the design of successive groups in the attempt to increase subsequent effectiveness. Group 1 had no PIM applied, group 2 had a single PIM applied and group 3 had two PIMs applied. Findings - The introduction of the single PIM for group 2 increased the effectiveness of clinical outcomes, while for group 3, the introduction of two PIMs increased effectiveness again in comparison to group 1, but not in comparison to group 2. Practice implications - The results indicate that the active use of feedback of outcomes from interventions conducted can be utilised to design and then evaluate the application of resultant PIMs. This represents attempts to introduce and operationalise the concept of continuous quality improvement in the delivery of a clinical service. Originality/value - The evaluation of PIMs is in its practical and methodological infancy and this initiative represents the first attempt to utilise PIMs in the design of Primary Care psychological services.