A quality management project in Israeli navy primary care clinics

The objective of this project was to establish a measurable process of continuous quality improvement of health care services in the Israeli naval primary care clinics. All navy clinics were surveyed at 6-month intervals. The quality of medical recording was evaluated, and instructive workshops were given on the matter. Real-time physician-patient interactions were evaluated, and immediate feedback was given to the examining physician. Complementary medical services were evaluated and steps toward improvement were taken. A total of 1043 medical records were examined. A general improvement in medical-record documentation (from a score of 6.0 +/- 2.5 to a score of 7.4 +/- 1.9, P < .001) was demonstrated during the first 3 years of the project. No significant change was noticed in the physician-patient interaction score. Complementary medical services improved from a score of 4.9 +/- 1.5 in 1994 to a score of 7.4 +/- 0.9 3 years later (P < .02). This project achieved a significant improvement in the quality of medical recording and of complementary medical services.