Suboptimal quality of type 2 diabetes care discovered through electronic feedback led to increased nurse–GP cooperation. A qualitative study

Abstract 

Aim

To understand the influence of electronic feedback system (EFS) on providing type 2 diabetes care in general practice using a qualitative approach embedded in a randomized controlled trial.

Method

All 160 general practitioners (GPs) randomized to receive EFS were invited. Thirteen GPs from two solo and two partnership practices were interviewed about their experience with the EFS which provided data on the quality of diabetes care in their practices. Data was analysed using a qualitative descriptive approach.

Results

All participants found the insight into the overall quality of their diabetes care beneficial. While the two solo practices reported of no changes, the EFS catalysed organisational changes in the two partnership practices by allocating a number of diabetes controls to nurses. Limited time and a lack of real-time data were main barriers towards using the system.

Conclusion

EFS used at an overall level provided an overview of the diabetes population which made GPs aware of the need to improve the quality of diabetes care. The EFS influenced partnership practices, but not solo practices, to hire nurses and allocate parts of diabetes care to them. The findings are important in the interpretation of the effect of EFS.

Keywords: Type 2 diabetes, Primary care, Quality improvement, Electronic feedback, Reorganisation of care, Nurse involvement