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Adherence to explicit strategies for common medical conditions.

Publication ,  Journal Article
Sullivan, RJ; Estes, EH; Stopford, W; Lester, AJ
Published in: Med Care
April 1980

Explicit strategies (protocols) were prepared by the staff of a primary care clinic for use as professional standards by physicians, nurse practitioners and physicians' assistants to improve care and facilitate quality assessment in cases of urinary tract infection and upper respiratory illness. Over a 2-year period, audit of 3,442 records for adherence to protocol guidelines revealed a variation with time of 38 to 100 per cent in checklist utilization and 55 to 100 per cent in compliance with specified procedures. Shifting patterns of clinic load and alterations in feedback mechanisms to providers had little relation to guideline adherence. The range in scores was attributed to patient symptom variability with subsequent difficulty applying explicit strategies, and to failure of providers to record details contributing to clinical decisions. With this range of "success" following self-imposed predefined strategies, it is not surprising that retrospective record reviews using short sample periods and criteria established by outside expert panels document wide variation in quality.

Duke Scholars

Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

April 1980

Volume

18

Issue

4

Start / End Page

388 / 399

Location

United States

Related Subject Headings

  • Therapeutics
  • Quality of Health Care
  • Primary Health Care
  • North Carolina
  • Humans
  • Health Policy & Services
  • Evaluation Studies as Topic
  • Delivery of Health Care
  • 4407 Policy and administration
  • 4203 Health services and systems
 

Citation

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Sullivan, R. J., Estes, E. H., Stopford, W., & Lester, A. J. (1980). Adherence to explicit strategies for common medical conditions. Med Care, 18(4), 388–399. https://doi.org/10.1097/00005650-198004000-00004
Sullivan, R. J., E. H. Estes, W. Stopford, and A. J. Lester. “Adherence to explicit strategies for common medical conditions.Med Care 18, no. 4 (April 1980): 388–99. https://doi.org/10.1097/00005650-198004000-00004.
Sullivan RJ, Estes EH, Stopford W, Lester AJ. Adherence to explicit strategies for common medical conditions. Med Care. 1980 Apr;18(4):388–99.
Sullivan, R. J., et al. “Adherence to explicit strategies for common medical conditions.Med Care, vol. 18, no. 4, Apr. 1980, pp. 388–99. Pubmed, doi:10.1097/00005650-198004000-00004.
Sullivan RJ, Estes EH, Stopford W, Lester AJ. Adherence to explicit strategies for common medical conditions. Med Care. 1980 Apr;18(4):388–399.

Published In

Med Care

DOI

ISSN

0025-7079

Publication Date

April 1980

Volume

18

Issue

4

Start / End Page

388 / 399

Location

United States

Related Subject Headings

  • Therapeutics
  • Quality of Health Care
  • Primary Health Care
  • North Carolina
  • Humans
  • Health Policy & Services
  • Evaluation Studies as Topic
  • Delivery of Health Care
  • 4407 Policy and administration
  • 4203 Health services and systems