Relationship between Process and Outcome in Ambulatory Care

Kane, Robert L; Gardner, Jerry D.; Wright, Diana Dryer; Snell, George F.; Sundwall, David N.; Woolley, F. Ross

doi:10.1097/00005650-197711000-00010

Cited by 14 publications

(2 citation statements)

References 7 publications

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“…The goal of this study was to assess the usefulness of a chart audit to monitor and teach the delivery of well child care to paediatric residents. The validity of this methodology has been proven in several studies that have demonstrated that medical records do provide a reliable record of the doctor‐patient interaction or are positively correlated with patient outcome (Rosenfeld 1957; Clute 1963; Donabedian 1969; Long & Rogers 1975; Zuckerman et al 1975; Kane et al 1977; Hulka et al 1979; Starfield et al 1979).…”

Section: Discussionmentioning

confidence: 99%

Use of a chart audit: teaching well child care to paediatric house officers

Mayefsky

Foye

1993

Medical Education

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A prospective study employing a randomly assigned control group was conducted to assess the usefulness of a chart audit in teaching paediatric residents the components of well child care. The charts of children less than 5 years of age were reviewed and compared with audit criteria. Per cent compliance scores were calculated for five categories: present history; behaviour-development; family history; past medical history; and physical assessment. Five separate audits (10 charts per resident per audit) were conducted--two prior to giving the residents feedback, one after informing them that a study was being conducted, once a month after giving feedback, and one a year later. There was no significant difference between the baseline scores of the two groups. In addition, there were no significant changes in the experimental group's scores during the first three audits or the control group's scores over the whole 3-year course of the study. However, one month after receiving feedback, the scores of the experimental group improved significantly in present history, behaviour-development, and past history. One year later, the experimental group's scores were lower in every category than in the preceding audit. However, their scores were higher than the control group and the difference reached statistical significance in present history. We conclude that regular chart audits with feedback are a valuable addition to the primary care curriculum in a paediatric residency programme.

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Section: Discussionmentioning

confidence: 99%

Use of a chart audit: teaching well child care to paediatric house officers

Mayefsky

Foye

1993

Medical Education

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show abstract

“…Previous studies of hypertension have rarely demonstrated links between processes and outcomes, [23][24][25][26] possibly because these studies aggregated the processes of care reported for several visits, whereas we studied in detail the process of care at single visits. Only Haynes et al reported that the vigor of therapy, defined on the basis of the relative potency of various antihypertensive drugs, was associated with decreases in diastolic blood pressure.…”

Section: No Yesmentioning

confidence: 99%