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Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature

There is growing awareness of the need to improve quality in health care, including in primary care.14 In Australia, this is witnessed by the National Primary Health Care Strategy, with its focus on the importance of quality as a foundation and driver of change.2 There is also an ongoing push for the development of new indicators for performance improvement, quality and safety benchmarking, and change management approaches and strategies for quality improvement (QI) in primary care.2

There are diverse terms and definitions used for QI,5 and varying QI strategies involving structured processes that include assessment, refinement, evaluation and adoption of processes used by individuals, teams, an organisation or a health system, with the aim to enhance some aspect of quality and achieve measurable improvements.6,7 These can include simple tools, such as flow charts and checklists; more complex multiple-method tools, such as re-engineering; and frameworks, such as the Plan, Do, Study, Act (PDSA) and audit cycles.8 These strategies have yielded modest change and are often not sustained over time.8,