Physician Involvement in Quality Assurance

Achieving health gain through clinical guidelines II: Ensuring guidelines change medical practice.

“…22 Emslie et al reported improvements in general practice management and referral of infertile couples when guidelines were embedded within an infertility management package.30 Many studies have reminded doctors about previous non-compliance with guidelines at the time of consultation: patients' notes are screened before the consultation, either by a trained health care professional or more often by a computer, and reminders are placed only in those notes not complying with the guidelines (tables 1, 2).7 8 11 13 compliance, introduction of a new x ray examination request form, and review of requests for x ray examinations by radiologists: all were moderately successful, none more so than the other three (table 3).62 In a sequential study Sommers et al compared the effect on managing unexplained low haemoglobin concentration of two different types of feedbackaggregated versus patient specific feedback: they found that both strategies improved compliance but patient specific feedback was better (table 1). 16 Lomas et al compared the effects of the traditional audit cycle with continuing education led by a local "opinion leader": they observed significant improvements in compliance with guidelines for caesarean sections only for the opinion leader." McPhee et al compared computer generated reminders placed in patients' notes with aggregated feedback to promote cancer screening; both strategies were successful but reminders were better (table 2).…”

“…Developmient, disseoioatiOn, and ioplemeuntation strategies adopted bv rigorous evaluatiOns of gidelieoes for clinical care ++ Significant improvement[10][11][12][13][14][15][16][17][18][19] 90 in absolute terms. ±++ Significant improvement 20-29-9°/o in absolute terms .+++.Significant improvement 30!/, in absolute terms needed to develop guidelines.…”

Managed Care for Preventive Services: A Review of Policy Options

“…A 1980 conference on Pap smears, for example, did not improve physician compliance with Pap smear recommendations (Perry 1987). Another study showed relatively lower compliance with quality assurance criteria by physicians involved in creating the criteria (Sommers et al 1984). …”

A model for quality assessment in primary health care using the tracer condition technique with insulin treated diabetes as one of the tracers

“…Such models of quality assurance and quality improvement have been used in Europe (2)(3)(4)(5)(6) and USA (7). hospital and 87 insulin treated patients attending the health centres.…”