Table 1 Description of the different parts of the intervention model (SÄKLÄK)
1. Introductory meeting | Representatives from the steering committeea visited the primary care units, gave a structured introduction to the intervention model for unit managers and staff representatives, including nurses working in home care and pharmacists. The involvement of all professional categories was presented as a prerequisite for the self-assessment process. |
2. Structured self-assessment | The self-assessment questionnaire contained 12 questions covering areas of importance for safe use of medications in primary care, with focus on elderly patients with multiple diseases. The head of the primary care unit was responsible for the self-assessment, which was carried out together with all professional categories as well as cooperating caregivers. |
3. Peer review | A group of physicians, nurses and pharmacists selected by the professional organisationsb served as reviewers. For each primary care unit, a multi-professional team consisting of five to six reviewers was formed, which discussed the answered self-assessments. The primary care units were visited by a peer-review team. A document based on the questions used in the self-assessment procedure served as support for the peer review where new or updated information arising during the visit was noted. |
4. Written feedback and agreement for change | The peer-review team presented a written feedback report regarding their view on strengths and weaknesses, priority areas for improvement and proposed measures to be taken. Eventually, a written contract consisting of a detailed action plan was jointly produced by the primary care unit and the peer-review team. |
5. Follow-up seminar | A seminar for the steering committee, the reviewers and all managers at the intervention primary care units. |
6. Follow up on accomplishment of agreements | The agreements for change were to be followed up on 6 months after they were signed. |