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Published on: February 16, 2011
Improving delivery of clinical preventive services: a multi-year journey
David J Ballard1, David A Nicewander, Huanying Qin
1Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas 75206, USA. dj.ballard@baylorhealth.edu
Background:
Adults in the United States typically do not receive all recommended clinical preventive services (CPS) for which they are eligible, missing opportunities for prevention and/or early detection. A multi-year quality improvement initiative targeting CPS delivery in a fee-for-service ambulatory care network is described.
Methods:
Since 1999, HealthTexas Provider Network (HTPN) has implemented multiple initiatives to increase CPS delivery, including a flowsheet, a physician champion model, physician- and practice-level audit and feedback, and rapid-cycle quality improvement training.
Results:
From 2000 to 2006, "recommended or done" CPS delivery increased from 68% to 92%, and "done" from 70% to 86% (2001 to 2006). "Perfect care" composite performance increased from 0.19 to 0.51 (2001 to 2006).
Conclusions:
Long-term, multistrategy approaches can achieve substantial sustained improvement in CPS delivery throughout a large ambulatory care provider network.
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