Improving quality improvement using achievable benchmarks for physician feedback - A randomized controlled trial
Improving quality improvement using achievable benchmarks for physician feedback - A randomized controlled trial
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DOI：
10.1001/jama.285.22.2871
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发表时间：
2001-06-13
影响因子：
120.7
通讯作者：
Weissman, NW
中科院分区：
文献类型：
--
作者：
Kiefe, CI;Allison, JJ;Weissman, NW
绩效反馈和基准测试是改善医疗保健的常用工具，很少在随机试验中进行研究。可实现的护理基准（ABCs）是由同行群体中最优秀的表现者所达到的卓越标准，并且可以根据现有的表现数据容易地和可重复地计算。目的评估使用可实现的基准来增强典型的医生表现反馈和改善护理的有效性。随访至1998年。设置和参与者70名社区医生和2978名参加亚拉巴马门诊护理质量改善项目的按服务收费的医疗保险糖尿病患者。干预医生被随机分配接受多模式改善干预，包括病历审查和医生特定反馈（对照组; n=35）或相同的干预加上可实现的基准反馈（实验组; n=35）。主要结果测量干预前（1994-1995年）（1997-1998年）接受流感疫苗注射的病人比例的变化;足部检查;结果实验组流感疫苗接种率由40%提高到58%（P
Context Performance feedback and benchmarking, common tools for health care improvement, are rarely studied in randomized trials. Achievable Benchmarks of Care (ABCs) are standards of excellence attained by top performers in a peer group and are easily and reproducibly calculated from existing performance data.Objective To evaluate the effectiveness of using achievable benchmarks to enhance typical physician performance feedback and improve care.Design Group-randomized controlled trial conducted in December 1996, with follow-up through 1998.Setting and Participants Seventy community physicians and 2978 fee-for-service Medicare patients with diabetes mellitus who were part of the Ambulatory Care Quality Improvement Project in Alabama.Intervention Physicians were randomly assigned to receive a multimodal improvement intervention, including chart review and physician-specific feedback (comparison group; n=35) or an identical intervention plus achievable benchmark feedback (experimental group; n=35).Main Outcome Measure Preintervention (1994-1995) to postintervention (1997-1998) changes in the proportion of patients receiving influenza vaccination; foot examination; and each of 3 blood tests measuring glucose control, cholesterol level, and triglyceride level, compared between the 2 groups.Results The proportion of patients who received influenza vaccine improved from 40% to 58% in the experimental group (P