Improving Charting Skills of Physicians in Monitored Practice.

Area of Science:

• Medical Education
• Physician Performance Improvement
• Quality Assurance in Healthcare

Background:

• Physician dyscompetency requires effective monitoring and remediation strategies.
• In-practice monitoring programs, such as the Physician Enhancement Program (PEP), offer a structured approach to address physician performance issues.
• Chart audits are a key component of PEP, providing objective data on physician charting quality.

Purpose of the Study:

• To evaluate the impact of the Physician Enhancement Program (PEP) on physicians' charting skills.
• To determine if participation in PEP leads to measurable improvements in the quality of physician documentation.

Main Methods:

• A sample of 77 physicians participating in PEP for at least six months was analyzed.
• Chart audits assessed seven quality elements (legibility, organization, history, assessment/formulation, treatment, physical examination, overall quality) using a 1-9 Likert scale.
• Pair-matched t-tests compared mean scores at baseline (month 1) and subsequent intervals (months 6, 12, 18, 24) for six elements.

Main Results:

• Significant improvements (P < .002) were observed in six chart quality elements at months 6, 12, 18, and 24.
• Physicians with lower initial overall chart quality scores demonstrated the most substantial improvement.
• Physicians with high initial scores showed minimal change, indicating a ceiling effect.

Conclusions:

• Participation in the Physician Enhancement Program (PEP) leads to demonstrable improvements in physician charting skills.
• PEP serves as an effective educational tool, driving positive physician behavior change.
• The program is particularly beneficial for physicians requiring the most significant performance enhancement.