This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schectman, J. M. Articles by Voss, J. D. Search for Related Content PubMed PubMed Citation Articles by Schectman, J. M. Articles by Voss, J. D. Social Bookmarking                   What's this?

The Effect of Physician Feedback and an Action Checklist on Diabetes Care Measures

Department of Medicine, University of Virginia, Charlottesville, Va, js3dv{at}virginia.edu

John B. Schorling, MD, MPH

Department of Medicine, University of Virginia, Charlottesville, Va

Mohan M. Nadkarni, MD

Department of Medicine, University of Virginia, Charlottesville, Va

Jason A. Lyman, MD, MPH

Department of Health Evaluation Sciences, University of Virginia, Charlottesville, Va

Mir S. Siadaty, MD

Department of Health Evaluation Sciences, University of Virginia, Charlottesville, Va

John D. Voss, MD

Department of Medicine, University of Virginia, Charlottesville, Va

The objective was to evaluate whether physician feed-back accompanied by an action checklist improved diabetes care process measures. Eighty-three physicians in an academic general medicine clinic were provided a single feedback report on the most recent date and result of diabetes care measures (glycosylated hemoglobin [Alc, urine microalbumin, serum creatinine, lipid levels, retinal examination) as well as recent diabetes medication refills with calculated dosing and adherence on 789 patients. An educational session regarding the feedback and adherence information was provided. The physicians were asked to complete a checklist accompanying the feedback on each of their patients, indicating requested actions with respect to follow-up, testing, and counseling. The physicians completed 82% of patient checklists, requesting actions consistent with patient needs on the basis of the feedback. Of the physicians, 93% felt the patient information and intervention format to be useful. The odds of urine microalbumin testing, serum creatinine, lipid profile, Alc, and retinal examination increased in the 6 months after the feedback. The increase was sustained at 1 year only for microalbumin and retinal exams. There was no significant change in refill adherence for the group overall after the feedback, although adherence did improve among patients of physicians attending the educational session. No significant change was noted in lipid or Alc levels during the study period. In conclusion, a simple physician feedback tool with action checklist can be both helpful and popular for improving rates of diabetes care guideline adherence. More complex interventions are likely required to improve diabetes outcomes.

Key Words: Adherence • checklist • diabetes care • physician education • physician feedback

American Journal of Medical Quality, Vol. 19, No. 5, 207-213 (2004)
DOI: 10.1177/106286060401900505


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. Hales, M. Terblanche, R. Fowler, and W. Sibbald Development of medical checklists for improved quality of patient care Int. J. Qual. Health Care, February 1, 2008; 20(1): 22 - 30. [Abstract] [Full Text] [PDF]