Journal of Continuing Education in the Health Professions



HOME \| SITE MAP \| CONTACT US
Your Location: Home > Volume 26, Issue 4

CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 26 (4) Volume 26, Issue 4, Fall 2006 J Contin Educ Health Prof 2006; 26(4):268-284 RESEARCH ARTICLE JCEHP AWARD FOR EXCELLENCE IN RESEARCH Full Text Integrating education into primary care quality and cost improvement at an academic medical center R. Van Harrison Connie J. Standiford Lee A. Green Steven J. Bernstein A b s t r a c t 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. Lessons for Practice Identify priority areas for improving clinical care quality and cost-effectiveness. Develop consensus and measure performance on important aspects of care. Maintain a systemwide view of interrelated actions needed to improve performance. Tailor improvement plans to particulars of the medical condition. Educate physicians about practical and operational issues and biological science as one component of a comprehensive plan for change. Adapt CME and change activities for physicians into education and training for residents and medical students, providing feedback on important aspects of care to assess past success and to direct future change efforts. Key Words: continuing medical education, physician performance change, primary care, systems-based care, quality improvement, cost-effective care
HOME \| SITE MAP \| CONTACT US Copyright © 1996-2012 JCEHP.com & The Journal of Continuing Education in the Health Professions All rights reserved Disclaimer · About This Site · Web Editor · Make JCEHP Your Homepage Information on this site was last updated: 04 April 2012