A Randomized Controlled Trial of Quality Assurance in Sixteen Ambulatory Care Practices
Bibliographic Data
| ID | 9100275 |
|---|---|
| Authors | R Heather Palmer (Institute for Community Health, corresponding author), Thomas A Louis (0000-0002-3592-6386, Harvard University), Lee-Nah Hsu, Harriet F Peterson (Harvard University), Janet K Rothrock (Institute for Community Health, corresponding author), Rose Strain (Harvard University, corresponding author), Mark S Thompson (0000-0001-8958-0336, Harvard University, corresponding author), ELIZABETH A WRIGHT (Harvard University) |
| Year | 1985 |
| Volume | 23 |
| Issue | 6 |
| Pages | 751-770 |
| Publication date | 1985-06-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-198506000-00001 |
| PMID | 3892184 |
| OpenAlex | W2000986281 |
| Language | EN |
| Citations received | 19 |
| References cited | 6 |
A crossover randomized controlled trial of cycles of quality assurance in 16 primary care (8 medical, 8 pediatric) group practices was conducted. Of four medical and four pediatric tasks important to patient outcome, two were randomly assigned to experimental intervention (a quality assurance cycle), and two were also measured and used as blinded controls for each medical or pediatric group practice. Task performance was measured in each group for 12 months prior to, 9 months during, and 9 months after the experimental intervention, using as a performance score the percentage of evaluation criteria failed of those applicable to a case. As a result of quality assurance intervention, quality of performance was significantly improved in two of the tasks (P less than 0.0001, with 6.7, and 9.8 percentage points improvement), and marginally improved in one task (P = 0.06, 5.7 percentage points improvement). Surprisingly, tasks with lower perceived effect on patient health (low physician motivation) had greater improvement in quality. Unimproved tasks were associated with the perceived need for delivery system changes beyond the immediate control of the individual practitioner
Alternative medicine · Ambulatory · Ambulatory care · Crossover study · Family medicine · Health care · Intervention (counseling) · Medical care · Operations management · Physical therapy · Quality assurance · Quality management · Randomized controlled trial · Task (project management) · Childhood Cancer Survivors' Quality of Life · Emergency Medicine · Health Systems, Economic Evaluations, Quality of Life · Internal Medicine · Medicine · Nursing · Patient Satisfaction in Healthcare
Performance Quality, Gender, and Professional Role
VB. Influence of Organizational Components on the Delivery of Asthma Care
The Impact of Patient Management Guidelines on the Care of Breast, Colorectal, and Ovarian Cancer Patients in Italy
A Randomized Trial of Quality Assurance in Nursing Homes
Comparison of Vignettes, Standardized Patients, and Chart Abstraction
The health service coverage of quality-certified primary health care units in Metro-Manila, the Philippines
Evaluation of medical audit
Interventions to improve the delivery of preventive services in primary care
What Makes Quality Assurance Effective
The Ambulatory Care Medical Audit Demonstration Project
Assessing the Comparability of Various Measures of the Quality of Ambulatory Care
Consistency in Performance Among Primary Care Practitioners
Developing a Reliable, Valid, and Feasible Plan for Quality-of-Care Measurement for Cancer
Practice Characteristics and Performance of Primary Care Practitioners
Leadership for Quality Improvement in Group Practices
Are Differences in Practitioners' Acceptance of a Quality Assurance Intervention Related to Their Performance
Quality Improvement Among Primary Care Practitioners
Issues of Variability and Bias Affecting Multisite Measurement of Quality of Care
Capturing Quality
A Review of Physician Cost-Containment Strategies for Laboratory Testing
A computer-based record and clinical monitoring system for ambulatory care
Resource requirements for evaluating ambulatory health care
Quality Assurance through Automated Monitoring and Concurrent Feedback Using a Computer-Based Medical Information System
Improving Physician Compliance With Preventive Medicine Guidelines
A Computer-Based Monitoring System for Follow-Up of Elevated Blood Pressure
| Citations per year | 0.49 |
|---|---|
| Citation span | 1987 - 2006 (20) |
| Highly cited | No |