This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Lessons From the Literature

Elizabeth M. Yano, MSPH; Arlene Fink, PhD; Susan H. Hirsch, MPH; Alan S. Robbins, MD; Lisa V. Rubenstein, MD, MSPH

Arch Intern Med. 1995;155(11):1146-1156.

Abstract
We reviewed rigorous evaluations of programs to enhance the quality and economy of primary care. We identified 36 evaluations published from 1980 through 1992. We abstracted data on objectives, setting(s), patients and processes, outcomes, and costs of care. We identified successful programs, as well as significant gaps in our knowledge of how to improve aspects of care. In specific, computer reminders and social influence—based methods fostered preventive and economic care. Nurse implementation of prevention protocols increased their performance. Multidisciplinary teams improved access and economy. Regional organization of practices or telephone management improved access; regionalization also reduced emergency care. Improvements were not found in continuity, comprehensiveness, humanistic process, physical environment, or health outcomes. Primary care practices can implement several programs to continuously improve prevention and access, and to reduce costs and use of unnecessary services. Research documenting how to accomplish other major goals, including health outcome changes, in different practice types is needed.

(Arch Intern Med. 1995;155:1146-1156)

Author Affiliations
From the Evaluation and Decision Support Service, and the Department of Veterans Affairs Center for the Study of Healthcare Provider Behavior, Veterans Health Administration Medical Center, Sepulveda, Calif.

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

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Implementation of Evidence-Based Preventive Services Delivery Processes in Primary Care: An Oklahoma Physicians Resource/Research Network (OKPRN) Study
Mold et al.
J Am Board Fam Med 2008;21:334-344.
ABSTRACT | FULL TEXT  

Self-Reported Performance Improvement Strategies of Highly Successful Veterans Health Administration Facilities
Craig et al.
American Journal of Medical Quality 2007;22:438-444.
ABSTRACT  

The Evolution of Changes in Primary Care Delivery Underlying the Veterans Health Administration's Quality Transformation
Yano et al.
AJPH 2007;97:2151-2159.
ABSTRACT | FULL TEXT  

What Interventions Should Pharmacists Employ to Impact Health Practitioners' Prescribing Practices?
Grindrod et al.
The Annals of Pharmacotherapy 2006;40:1546-1557.
ABSTRACT | FULL TEXT  

A Collaborative Initiative to Improve the Care of Elderly Medicare Patients With Hypertension
Meehan et al.
American Journal of Medical Quality 2004;19:103-111.
ABSTRACT  

Lessons for cluster randomized trials in the twenty-first century: a systematic review of trials in primary care
Eldridge et al.
Clin Trials 2004;1:80-90.
ABSTRACT  

Patient satisfaction and quality of care in walk-in clinics, family practices and emergency departments: the Ontario Walk-In Clinic Study
Hutchison et al.
CMAJ 2003;168:977-983.
ABSTRACT | FULL TEXT  

Computers and the general practice consultation
Ellis and May
Health Informatics Journal 1999;5:124-127.
ABSTRACT  

A patient initiated computer program improved breast cancer screening practices in primary care
Kernohan
Evid. Based Nurs. 1999;2:57-57.
FULL TEXT  

Getting research findings into practice: Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings
Bero et al.
BMJ 1998;317:465-468.
FULL TEXT  

Improving Preventive Health Care in a Medical Resident Practice
Cardozo et al.
Arch Intern Med 1998;158:261-264.
ABSTRACT | FULL TEXT  

Periodic Health Examinations and the Provision of Cancer Prevention Services
Sox et al.
Arch Fam Med 1997;6:223-230.
ABSTRACT