Abstract
Introduction: In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists’ performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Methods: Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists’ documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Results: Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). Conclusion: This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve performance on national quality measures for RA.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 141-151 |
| Number of pages | 11 |
| Journal | Rheumatology and Therapy |
| Volume | 2 |
| Issue number | 2 |
| DOIs | |
| State | Published - Dec 2015 |
Funding
Sponsorship for this study was funded by an educational grant from Genentech (South San Francisco, CA, USA). Sponsorship for article development and processing charges was funded by PRIME Education, Inc. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. The authors presented the study results at the annual meeting of the Alliance for Continuing Education in the Health Professions in January 2015. Sponsorship for this study was funded?by an educational grant from Genentech (South San Francisco, CA, USA). Sponsorship for article development and processing charges was funded by PRIME Education, Inc. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. The authors presented the study results at the annual meeting of the Alliance for Continuing Education in the Health Professions in January 2015. Tamar Sapir, Erica Rusie, Jeffrey Carter, Laurence Greene, and Kathleen Moreo represent PRIME Education, Inc., a healthcare education company that received an independent educational grant from Genentech to conduct the quality improvement project described in this article. Genentech had no role in the study design or execution, and the grant did not include support for writing this manuscript or paying publication charges. Barry Patel represents Indegene Total Therapeutic Management, a research company contracted by PRIME Education to perform the chart audits for this study. Jinoos Yazdany, Mark Robbins, and Eric Ruderman received honoraria from PRIME Education, Inc. for participation as faculty in the project?s continuing education activities. The authors did not receive payment for writing this article. The QI education program and outcomes study were approved by an independent institutional review board (Sterling IRB, Atlanta, GA; IRB ID #4534). This article does not contain any new studies with human or animal subjects performed by any of the authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords
- Chart audit
- Continuing medical education
- Physician Quality Reporting System
- Quality improvement
- Quality measures
- Rheumatoid arthritis
ASJC Scopus subject areas
- Rheumatology
- Immunology and Allergy
