Question

Discuss all the services and policies you think are important for a high-quality general practice. Consider both clients’ and professionals’ perspectives in the office. Include Reference

Answer 1

Ans) There are divergent logics and tensions within different aspects of quality, where patient-centredness requires specific attention to individual needs, and efficiency which can be supported by rationalisation and mass production.

- These different logics can be experienced as dilemmas in clinicians’ everyday practices.

- Whilst quality systems often operate according to that which is measureable, the difficulty of this approach is that the intangible, relational and tacit elements of care become less visible within health systems.

- It has been exemplified through this paper that services and knowledge management practices and ethics of care literature have important contributions to make to the quality agenda within health services.

- Ethics of care theory begins from a relational, interconnected ontology as opposed to that of an autonomous rational actor.

- This relational ontology can provide a stronger grounding logic for developing organisations on a basis of interpersonal care.

- Services management literature highlights the importance of how quality is co-produced in everyday service interactions between staff and service users through a relational process.

- Knowledge management literature provides a range of tools and techniques that can be used to manage and support quality, including reflective spaces, communities of practice and collective learning.

- It has been illustrated that these approaches may align with elements of staff values, motivation and commitment to professional learning and development, complimenting rationalised measurement systems to support the intangible and tacit dimensions of quality.

- Theories that build on understandings of care as a connected, interdependent and relational process may provide stronger building blocks for achieving that which Robert Francis identifies as essential within the health service; to improve care and put the patient first.