ERIC Number: EJ759258
Record Type: Journal
Publication Date: 2006
Reference Count: N/A
Integrating Education into Primary Care Quality and Cost Improvement at an Academic Medical Center
Harrison, R. Van; Standiford, Connie J.; Green, Lee A.; Bernstein, Steven J.
Journal of Continuing Education in the Health Professions, v26 n4 p268-284 Fall 2006
Introduction: In 1996 the University of Michigan Health System created the Guidelines Utilization, Implementation, Development, and Evaluation Studies (GUIDES) unit to improve the quality and cost-effectiveness of primary care for common medical problems. GUIDES's primary functions are to oversee the development of evidence-based, practical clinical guidelines for common medical conditions; measure and provide feedback on physicians' performance; and facilitate systemic changes to support appropriate care. Various methods are used to improve care, including evidence reviews, formal education, informal clinical "opinion leaders," feedback, reminders, and procedure changes. Twenty-four common medical conditions have been addressed through this process. More than 30 measures of clinical performance have been developed and reported. Methods: This case study describes a systematic, multifaceted program to improve the quality and cost-effectiveness of primary care. Results: Illustrative results for clinical performance are presented for 2 measures of chronic care, 2 measures of preventive care, and 2 measures of acute care. All 6 measures show general improvement in performance across years, with performance near or above the National Committee for Quality Assurance's 90th percentile for Health Plan Employer Data and Information Set measures. Discussion: A systematic approach involving all relevant components of a health system integrates the synthesis of information, education about the information and how to implement it, and addressing operational barriers. Benefits include a curriculum that is shared across faculty, residents, and medical students and more uniform quality of care that faculty model for physicians-in-training.
Descriptors: Physicians, Quality Control, Medical Education, Total Quality Management, Medical Care Evaluation, Professional Continuing Education, Clinical Teaching (Health Professions), Improvement Programs, Organizational Theories, Case Studies, Cost Effectiveness, Primary Health Care, Research Methodology
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Publication Type: Journal Articles; Reports - Research
Education Level: Higher Education
Authoring Institution: N/A
Identifiers - Location: Michigan