Developing a facilitation model to promote organisational development in primary care practices

Rhydderch, Melody; Edwards, Adrian; Marshall, Martin; Elwyn, Glyn; Grol, Richard

doi:10.1186/1471-2296-7-38

BMC Primary Care

Table 1 The Maturity Matrix and the role of the facilitator: An overview

From: Developing a facilitation model to promote organisational development in primary care practices

Eleven areas, known as dimensions, are covered by the Maturity Matrix and these are listed below. Each dimension consists of eight stages that describe a progression from very basic practice to more developed arrangements. For example, the first dimension, clinical data, describes how practices typically progress from having paper based systems to having computer based systems capable of storing and analysing information about prescribing, referrals and diagnostic coding.
Dimension	Description: Organisational activities that:
1. Clinical data	describe the development of a clinical records system.
2. Audit of clinical performance	that support the practice in undertaking audit activity.
3. Use of guidelines	describe the way that a practice uses clinical guidelines.
4. Clinician access to clinical information	ensure that health professionals have access to clinical information.
5. Prescribing	support the proactive use of prescribing data as a mechanism for quality improvement and cost containment.
6. Human resources	ensure attention to policies and systems to support staff management.
7. Continuing professional development	ensure education and training for health professionals and other practice staff is based on an organisational development plan.
8. Risk management	support the identification, analysis and management of clinical and non clinical risk.
9. Practice meetings	enable effective team meetings.
10. Sharing information with patients	support patients being given information that is evidence-based and tailored to their personal needs and contexts.
11. Learning from patients	recognise patients as an important source of feedback on the organisation of services and performance of the providers and the organisation.

Facilitator role and training
The facilitator liaises with the practice to arrange for as many members of the practice team as possible to be present. A session typically lasts 1 to 1.5 hrs. The facilitator introduces the Maturity Matrix, talks about the process and takes any questions or comments. They then give a copy of the instrument to each member of the practice team and ask them to complete the Maturity Matrix individually. It takes approximately ten minutes for participants to decide where they think their practice is with regard to each of the eleven dimensions. The facilitator then initiates a discussion about each dimension in turn, encouraging participants to move from individual perspectives to reach a team consensus about the practices existing levels of organisational development and how they would like to improve. At the end of the session, the facilitator summarises the main points and agrees the next steps with the practice. Facilitators attend a standardised training programme combining didactic input about the Maturity Matrix with simulated practice using role plays, video feedback and facilitated discussion.

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ISSN: 2731-4553

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