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In order to achieve this, the CKD clinic team may implement quality improvement processes to monitor outcomes and maximize patient benefits.
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Social identities aligned with the communities of practice into which healthcare professionals have been socialised contribute to intractable identity conflicts 17 that may have severe consequences for implementing quality initiatives.
13 14 Our second observation is that the people involved in implementing quality improvements hold different values about what is appropriate that may underpin particular interests.
While exclusively implementing quality measures or, in this case, expanding quality measures to include steroid taper plans, may not result in substantive behaviour change, there is evidence that quality measure enforcement with an incentive/penalty structure and public reporting of outcomes may positively impact the quality of care received by affected patients.
We implemented quality control procedures to identify unusual results.
It is possible that respondents may have believed that patient care quality was better in their hospitals simply because their hospitals had implemented quality-enhancing HITs.
The profitable agencies may be more likely to try to implement aggressive quality control because they understand the importance of quality control for nursing care, which directly affects the evaluation of the agency, as shown by previous studies [ 11, 12].
Households may imperfectly implement energy saving measures.
Hence, despite its limitations, this validation study may be useful for health planners, managers, clinicians and researchers from EU countries experiencing the same conditions as Greece and attempting to implement similar quality improvement programs in primary health care.
These strategies may have the greatest effect if implemented as quality improvement initiatives in collaboration with the leadership of health plans and clinic organizations.
Their input would be important to understand the experiences of service providers and what interventions may be implemented to enable them to provide quality care to MSM.
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