Abstract
We randomly allocated family physicians meeting explicit entry criteria to experimental and control groups to determine whether CME affects the quality of patient care. The experimental group received educational packages, the control group did not. These educational packages were closely matched with explicit criteria used in the indicator condition—our method of measuring the quality of care. The indicator conditions were divided into elective, mandatory and hidden categories. We compared over 4,500 patient encounters, before and after the educational maneuver, with explicit clinical criteria in the indicator condition. These episodes of care were then classified according to quality of care. Though knowledge increased from the educational packages, overall quality of care improved very little. If the topics were elective, quality of care improved equally in both the experimental and control groups. When the topics were mandatory, quality of care provided by the experimental group improved (P < 0.05). Topics covered by the hidden indicator conditions showed no spillover effect.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chambers L. W., Burke M., Ross J., Cantwell R. Quantitative assessment of the quality of medical care provided in five family practices before and after attachment of a family practice nurse. Can Med Assoc J. 1978 May 6;118(9):1060–1064. [PMC free article] [PubMed] [Google Scholar]
- Chambers L. W., Sibley J. C., Spitzer W. O., Tugwell P. Quality of care assessment: how to set up and use an indicator condition. Clin Invest Med. 1981;4(1):41–50. [PubMed] [Google Scholar]
- Kessner D. M., Kalk C. E., Singer J. Assessing health quality--the case for tracers. N Engl J Med. 1973 Jan 25;288(4):189–194. doi: 10.1056/NEJM197301252880406. [DOI] [PubMed] [Google Scholar]
- Sibley J. C., Spitzer W. O., Rudnick K. V., Bell J. D., Bethune R. D., Sackett D. L., Wright K. Quality-of-care appraisal in primary care: a quantitative method. Ann Intern Med. 1975 Jul;83(1):46–52. doi: 10.7326/0003-4819-83-1-46. [DOI] [PubMed] [Google Scholar]
- Spasoff R. A., Lane P., Steele R. Quality of care in hospital emergency departments and family physicians' offices. Can Med Assoc J. 1977 Aug 6;117(3):229–232. [PMC free article] [PubMed] [Google Scholar]
- Spitzer W. O., Sackett D. L., Sibley J. C., Roberts R. S., Gent M., Kergin D. J., Hackett B. C., Olynich A. The Burlington randomized trial of the nurse practitioner. N Engl J Med. 1974 Jan 31;290(5):251–256. doi: 10.1056/NEJM197401312900506. [DOI] [PubMed] [Google Scholar]
