Perceived usefulness of nine quality improvement tools among Swiss physicians.

BACKGROUND Doctors' opinions about quality improvement tools likely influence their uptake and eventual impact on patient care. Little is known about physicians' perception of the comparative utility of various quality improvement tools. METHODS We conducted a mail survey of doctors in Geneva, Switzerland (2745 physicians, of whom 56% participated), to measure the perceived usefulness of 9 quality improvement tools. RESULTS In decreasing order of perceived utility these tools were regular continuous education (rated as very or extremely useful by 75% of respondents), mortality and morbidity conferences (65%), quality circles (60%), patient satisfaction measurement (42%), assessment of the fulfillment of therapeutic objectives (41%), assessment of compliance with guidelines (36%), periodic evaluation of doctors' skills (14%), onsite visits with peer-review of medical records (11%), and certification of office practices (8%). CONCLUSION Quality improvement tools seen as most useful by physicians are traditional methods such as continuous education and mortality and morbidity conferences. Methods that rely on the measurement of indicators or that have a judgmental component received less support.