Checklists in Family Medicine – a Developmental Study with Before/After-Comparison

DOI: 10.3238/zfa.2021.0018-0023

german translation / full article

Korbinian Saggau, Anina Höfle, Angela Schedlbauer, Susann Hueber, Marco Roos, Thomas Kühlein, Stefan Heinmüller

Keywords: diabetes non-attendance structured education

BackgroundQuality assurance in Germany focuses on support processes (requirements of hygiene etc.) rather than on quality of care (QOC). Systems that do focus on QOC are referred to as “clinical governance” (CG). We understand CG as a process of professional self-reflection and management. An electronic checklist (eCL) for Chronic Obstructive Lung Disease (COPD) was developed reminding doctors of important aspects of care, assuring adequate documentation, and generating data at the same time. We describe the development of the eCL and a before/after analysis of process-QOC for COPD-patients in a single group family practice.MethodsDevelopmental study with a before/after-analysis. To capture QOC at baseline (t0) electronic health records (EHR) of COPD-patients were surveyed using a guideline-based questionnaire. Our intervention was an eCL, which can be used within the EHR. Doctors and practice assistants were trained in the application of the eCL, its use remained optional. One year (t1) and four years (t2) after implementation QOC was reanalysed.ResultsAt t0 103 COPD patients were identified. For 58 % a spirometry was documented. Smoking status was recorded in 56 % and 34 % were vaccinated against influenza. After introduction of the eCL due to some changes in the practice 80 patients at t1 and 49 patients at t2 were identified. For 71 % (t1) and 63 % (t2) a spirometry was documented. Smoking status was documented in 75 % (t1) and 90 % (t2). Influenza vaccination was documented in 33 % (t1) and 55 % (t2) of patients.ConclusionsDevelopment and implementation of an eCL in the setting of our office within the EHR was possible. Our results indicate that the provision of an eCL together with a short introduction can help improve QOC. The eCL allows doctors to perform CG autonomously.Keywordschecklist; chronic disease; evidence-based medicine; family medicine; general practice

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