ESTABLISHING A QUALITY IMPROVEMENT PROCESS FOR IDENTIFICATION OF PSYCHOSOCIAL PROBLEMS IN A PRIMARY CARE PRACTICE

被引：10

作者：

BINGHAM, RL

PLANTE, DA

BRONSON, DL

TUFO, HM

MCKNIGHT, K

机构：

[1] Department of Psychiatry, University of Vermont

[2] Department of Medicine, University of Vermont

[3] Given Health Care Center, University Health Center, Burlington, Vermont, 05401, One South Prospect Street

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 1990年 / 5卷 / 04期

关键词：

case-finding instruments; primary care; psychosocial problem identification; quality improvement;

D O I：

10.1007/BF02600403

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objectives: A quality improvement process that will significantly increase the rate of identification of psychosocial problems through routine use of case-finding instruments can be established in a general medicine practice. Design: Two groups of patient examination reports written by physicians were retrospectively compared with the patients’ responses on the case-finding database instrument. The samples were obtained by sequential selection in four time periods. Setting and Patients: The study occurred in a university general internal medicine practice that utilizes the problem-oriented record. The patients studied were seen for first-time comprehensive examinations designed to identify all important bealth problems, including psychosocial problems. Intervention: The authors compared performances of the physicians in identification of psychosocial problems before and after the intervention, which consisted of a pilot study audit of psychosocial problem identification, establishment of standards for interpretation of the case-finding instrument, design of a flow sheet to make case-finding data clearly available to the physician at each comprebensive examination, and feedback of physician performance according to practice-adopted standards for identification of psychosocial problems. Measurement: The result of the intervention was an increase in psychosocial problem identification from 67% to 90% of problems present, p<0.05 by chi-square distribution; or a decrease from 33% to 10% in psychosocial problems missed by the physicians. Conclusion: The quality improvement process for identification of psychosocial problems described in this report significantly increased the rate of identification of psychosocial problems by general internists. © 1990, Society of General Internal Medicine. All rights reserved.

引用

页码：342 / 346

页数：5

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