The impact of self-assessment and surveyor assessment on site visit performance under the National General Practice Accreditation scheme.

David T McNaughton, Paul Mara, Michael P Jones
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Abstract

Objective There is a need to undertake more proactive and in-depth analyses of general practice accreditation processes. Two areas that have been highlighted as areas of potential inconsistency are the self-assessment and surveyor assessment of indicators. Methods The data encompass 757 accreditation visits made between December 2020 and July 2022. A mixed-effect multilevel logistic regression model determined the association between attempt of the self-assessment and indicator conformity from the surveyor assessment. Furthermore, we present a contrast of the rate of indicator conformity between surveyors as an approximation of the inter-assessor consistency from the site visit. Results Two hundred and seventy-seven (37%) practices did not attempt or accurately report conformity to any indicators at the self-assessment. Association between attempting the self-assessment and the rate of indicator non-conformity at the site visit failed to reach statistical significance (OR = 0.90 [95% CI = 1.14-0.72], P  = 0.28). A small number of surveyors (N  = 9/34) demonstrated statistically significant differences in the rate of indicator conformity compared to the mean of all surveyors. Conclusions Attempt of the self-assessment did not predict indicator conformity at the site visit overall. Appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified.

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自我评估和调查员评估对国家全科医生认证计划实地考察表现的影响。
目标需要对全科医生评审过程进行更积极、更深入的分析。方法数据包括 2020 年 12 月至 2022 年 7 月期间进行的 757 次评审访问。混合效应多层次逻辑回归模型确定了自我评估尝试与调查员评估指标符合性之间的关联。此外,我们还提供了调查员之间指标符合率的对比,作为实地考察中评估员之间一致性的近似值。结果277家(37%)医疗机构在自我评估时未尝试或准确报告任何指标的符合性。尝试自我评估与实地考察时指标不符合率之间的关系未达到统计学意义(OR = 0.90 [95% CI = 1.14-0.72],P = 0.28)。与所有调查员的平均值相比,少数调查员(N = 9/34)的指标符合率存在显著的统计学差异。在实地考察中,调查员之间的指标评估一致性达到了适当的水平。
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