Article Text

How well did Norwegian general practice prepare to address the COVID-19 pandemic?
  1. Ingvild Vatten Alsnes1,
  2. Morten Munkvik1,
  3. W Dana Flanders2 and
  4. Nicolas Øyane3
  1. 1Department of Public Health, University of Stavanger, Stavanger, Norway
  2. 2Department of Epidemiology, Emory University, Atlanta, Georgia, USA
  3. 3Centre of Quality Improvement in Medical Practices, Bergen, Norway
  1. Correspondence to Dr Ingvild Vatten Alsnes; ingvild.vatten{at}


Objectives We aimed to describe the quality improvement measures made by Norwegian general practice (GP) during the COVID-19 pandemic, evaluate the differences in quality improvements based on region and assess the combinations of actions taken.

Design Descriptive study.

Setting Participants were included after taking part in an online quality improvement COVID-19 course for Norwegian GPs in April 2020. The participants reported whether internal and external measures were in place: COVID-19 sign on entrance, updated home page, access to video consultations and/or electronic written consultations, home office solutions, separate working teams, preparedness for home visits, isolation rooms, knowledge on decontamination, access to sufficient supplies of personal protective equipment (PPE) and COVID-19 clinics.

Participants One hundred GP offices were included. The mean number of general practitioners per office was 5.63.

Results More than 80% of practices had the following preparedness measures: COVID-19 sign on entrance, updated home page, COVID-19 clinic in the municipality, video and written electronic consultations, knowledge on how to use PPE, and home office solutions for general practitioners. Less than 50% had both PPE and knowledge of decontamination. Lack of PPE was reported by 37%, and 34% reported neither sufficient PPE nor a dedicated COVID-19 clinic. 15% reported that they had an isolation room, but not enough PPE. There were no geographical differences.

Conclusions Norwegian GPs in this study implemented many quality improvements to adapt to the COVID-19 pandemic. Overall, the largest potentials for improvement seem to be securing sufficient supply of PPE and establishing an isolation room at their practices.

  • communicable disease control
  • epidemiologic measurements
  • general practice
  • infection control
  • quality improvement

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  • Contributors IVA, MM and WDF contributed to the design, analyses and writing of the manuscript. NØ contributed to the idea, design and writing of the manuscript.

  • Funding IVA and MM received a grant from the Research Fund for Primary Care in Rogaland, Norway (part of the Norwegian Medical Association) to evaluate the responsiveness of Norwegian GP offices in the face of the COVID-19 pandemic. Otherwise the authors received no external funding to conduct this work.

  • Competing interests WDF owns a company, Epidemiologic Research & Methods, which does consulting work. He knows of no conflicts of interest with this work.

  • Patient consent for publication Not required.

  • Ethics approval According to the Norwegian Act on Medical and Health Research, the study did not require approval from the Regional Committee for Medical and Health Research Ethics because data were originally gathered as part of a quality improvement (QI) initiative and not primarily for research purposes. This was also the conclusion by the Regional Committee for Medical and Health Research Ethics (ref 2019/422) done for a similar and recent study that has been submitted and is currently under review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.