Document Detail


Improving quality in an internal medicine residency program through a peer medical record audit.
MedLine Citation:
PMID:  19940590     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study examined the effectiveness of a quality improvement project of a limited didactic session, a medical record audit by peers, and casual feedback within a residency program. METHOD: Residents audited their peers' medical records from the clinic of a university hospital in March, April, August, and September 2007. A 24-item quality-of-care score was developed for five common diagnoses, expressed from 0 to 100, with 100 as complete compliance. Audit scores were compared by month and experience of the resident as an auditor. RESULTS: A total of 469 medical records, audited by 12 residents, for 80 clinic residents, were included. The mean quality-of-care score was 89 (95% CI = 88-91); the scores in March, April, August, and September were 88 (95% CI = 85-91), 94 (95% CI = 90-96), 87 (95% CI = 85-89), and 91 (95% CI = 89-93), respectively. The mean score of 58 records of residents who had experience as auditors was 94 (95% CI = 89-96) compared with 89 (95% CI = 87-90) for those who did not. The score significantly varied (P = .0009) from March to April and from April to August, but it was not significantly associated with experience as an auditor with multivariate analysis. CONCLUSIONS: Residents' compliance with the standards of care was generally high. Residents responded to the project well, but their performance dropped after a break in the intervention. Continuation of the audit process may be necessary for a sustained effect on quality.
Authors:
Keiko Asao; Ishak A Mansi; Daniel Banks
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  84     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-26     Completed Date:  2009-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1796-802     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA.
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / therapy
Diabetes Mellitus / therapy
Health Status Indicators
Hospitals, University / standards
Humans
Hypertension / therapy
Internal Medicine / education*
Internship and Residency / standards*
Louisiana
Medical Audit / organization & administration*
Multivariate Analysis
Outpatient Clinics, Hospital / standards
Patient Care / standards
Pulmonary Disease, Chronic Obstructive / therapy
Ventricular Dysfunction, Left / therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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