Improving medical grand rounds: recommendations.

Background: The literature provides increasing evidence on how continuing medical education (CME) programs can change provider behavior and improve patient outcomes. Few authors discuss the application of those findings on a relatively common CME activity--grand rounds. Two recent publications about a case study of Medical Grand Rounds provide such an opportunity.

Improving medical grand rounds: barriers to change.

Background: Grand rounds programs may not be consistently structured to bring benefit from evidence-based practices of effective continuing medical education. In order to make improvements in this common educational forum, educational leaders need to consider and possibly overcome some barriers as perceived by planners, presenters, and participants. Research on perceived barriers to improving grand rounds is lacking.

A case study of medical grand rounds: are we using effective methods?

Background: Grand rounds are a time-honored continuing medical education activity that is intended to keep doctors current and competent. In addition, health care leaders and medical educators often rely on grand rounds to change physician behavior and improve patient outcomes. However, the extent to which grand rounds programs are consistent with evidence-based educational practices is unknown.

A descriptive study of educational outreach to promote use of quality improvement tools in primary care private practice.

The objective of this study was to describe the experience of a Quality Improvement Organization (QIO) providing educational outreach to promote use of quality improvement (QI) tools in primary care private practice. Two QIO outreach workers conducted visits with physicians and targeted staff. Data were analyzed on physician demographics, visits, and use of QI tools using standard quantitative and qualitative methods.

Understanding barriers to participation in mammography by women with disabilities.

Purpose: The study purpose was to identify barriers to mammography screening among women with different disabilities and to suggest interventions to address barriers.

Methods: Forty-two women with self-reported disabilities, ages 40 to 69 years participated. They resided in 24 Connecticut towns, and most had a prior mammogram.

Physicians' views on public reporting of hospital quality data.

This article describes physicians' responses to patient questions and physicians' views about public reports on hospital quality. Interviews with 56 office-based physicians in seven states/regions used hypothetical scenarios of patients questioning referrals based on public reports of hospital quality. Responses were analyzed using an iterative coding process to develop categories and themes from data.

Lessons learned from performance feedback by a quality improvement organization.

Performance feedback is a common quality improvement (QI) intervention strategy in the outpatient setting. This article describes the use by one quality improvement organization (QIO) of performance feedback to primary-care physicians with claims-based measures relating to diabetes, adult vaccinations, and mammography screening. Feedback from the physicians identified themes relating to data accuracy, methodology of the feedback reports, reasons for low performance rates, and suggestions on how the QIO could improve its intervention strategy.

The state of physician office-based health information technology in Connecticut: current use, barriers and future plans.

Qualidigm and the Connecticut State Medical Society-Independent Practice Association (CSMS-IPA), Inc. have conducted a survey of the physicians participating in the CSMS-IPA to assess current use of health information technology in their offices and their plans for future use. The survey was conducted to assist eHealth Connecticut, a Connecticut-based nonprofit organization, in its charge to promote electronic health information exchange in Connecticut.

Profiling variations in outpatient care for Medicare beneficiaries in Connecticut.

Qualidigm, the Medicare Quality Improvement Organization for Connecticut, is reporting the rates of four outpatient services for Medicare beneficiaries on its website (www.qualidigm.org).

Using public reports of patient satisfaction for hospital quality improvement.

Objective: To explore the impact of statewide public reporting of hospital patient satisfaction on hospital quality improvement (QI), using Rhode Island (RI) as a case example.

Data Source: Primary data collected through semi-structured interviews between September 2002 and January 2003.

Study Design: The design is a retrospective study of hospital executives at all 11 general and two specialty hospitals in RI.