1 | The methodology relies on voluntary participation and a bottom-up approach. |
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2 | The APO method is most useful for topics in need of quality improvement. |
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3 | The method is most suitable for a prospective registration of topics frequently occurring in a specific setting, such as at least 30 times/registration period. |
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4 | The registration period should last between 1 and 20 days depending on the frequency of the topic being investigated. |
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5 | At most, 10 main groups and a maximum of 45 variables are used to describe the topic being investigated. |
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6 | The main groups need to be lined up in a logical way, simulating the way patients are attended in the specific setting. |
For example, in the general practice setting: type of contact, symptoms, examinations, diagnosis, treatment, and assessment. |
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7 | Preferably a maximum of 10 variables per main group. The variables in each group need to be exhaustive (include all possibilities) and exclusive (no overlapping of variables). |
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8 | The main groups and variables are entered vertically into the APO A4 paper template. |
The participants fill in one horizontal line for each case. |
At least one tick per main group is needed. |
As a general rule only ticks are allowed (no writing). |
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9 | Data originating from the registration should be able to be used for quality assessment by means of quality indicators. |
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10 | A short instruction (maximum one page) needs to be provided for all participants. The instruction must specify the registration period, the inclusion and exclusion criteria, and briefly explain the content of each main group. |
Information about where to return the completed charts is clearly stated. |
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11 | Importantly, pilot testing needs to be done to ensure that the content of the registration chart is easily understood, and to confirm that enough cases are available. |
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12 | Registration charts have to be adapted to the reality of the area/country where the audit takes place. |
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13 | A local contact person needs to be available for questions from the participants. |