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The Nordic method for quality improvement in general practice

Anders Munck

In this paper we report our ten-year experience of a project for quality improvement in general practice in the Nordic countries. The quality improvement initiative is called the Audit Project Odense (APO) method. This has become increasingly popular among general practitioners in the Nordic countries since the early 1990s. APO is an integrated part of the Research Unit of General Practice at the University of Southern Denmark and has established a network of general practitioner (GP)representatives from all Danish counties and all the Nordic countries. The APO method is an easy to use instrument for GPs, which includes registration of their own activities, courses, follow-up and an evaluation. The APO method is suitable for addressing topics that play a central role in the work of GPs. The problem should befrequently occurring – at least 30 times in a two- to four-week period – and it should be possible to elucidate it by means of a special APO registration chart. The major advantage of the APO method is the simplicity of the registration chart used to submit data, and a process that ensures that the quality circle is completed. An  mportant feature of the APO concept is that it is voluntary – which increases motivation, and gives a sense of ownership and individual beneŽ t. Furthermore, the indepthand varying activities in the APO circle are considered beneŽ cial, and there are several examples of successful APO circles, where the e¡ects may last for several years. Due to the design of the evaluation, however, the evidence of the APO method’s e¡ectiveness could be stronger, and further evaluation is still needed