Box 2.

Checklist for evaluating quality of a consultation for chronic obstructive pulmonary disease with a mild exacerbation and history of hypertension

Duration of dyspnoea

Severity of dyspnoea

Any similar previous episodes

History of asthma, emphysema, or chronic obstructive pulmonary disease

Medications taken

Presence of fever

Presence of cough

Quality of cough

History of hypertension

History of high cholesterol concentrations

Exposure to allergens or other irritants at workplace

Smoking history

Alcohol use

Last flu or tetanus shots

Last Pneumovax

Marital status

Job or other social history

Blood pressure (both arms)

Palpation of jugular vein distension or point of maximal impulse

Chest auscultation

Lung auscultation

Examination of digits for cyanosis or clubbing

Examination of lower legs for oedema

Peak flow evaluation

Pulse oximetry (or arterial blood gas analysis)

Rectal/prostate examination

Diagnosis of chronic obstructive pulmonary disease, emphysema, or  bronchitis

Discussion of severity of chronic obstructive pulmonary disease

Diagnosis of hypertension or discussion of need to continue taking  medication for hypertension

Consulted with an attending physician

Verified proper use of inhaler(s)

Told to drink more fluids

Told to call or return if symptoms worsen

Told needed oxygen or intravenous fluids or to go to the emergency room  (not necessary)

Wanted to admit patient to hospital (not necessary)

Discussed smoking cessation

Counselled on diet

Counselled on exercise

Recommended, advised, or referred to have colon cancer screening

Follow up appointment recommended