Clinical Assessment Program for Residencies

Pilot Study

The CAP Pilot Study contains the findings of an analysis of eleven (11) AOA accredited osteopathic family practice residency programs that voluntarily participated in 2000 in a profession-wide continuous quality improvement initiative designed to analyze and compare their current clinical practices as measured against consensus recommendations and contemporary practice standards.

The pilot study measured current clinical practices for key process indicators selected from evidence-based consensus recommendations for diabetes, women’s health, childhood immunizations and osteopathic examination of the spine (OMM). Data was gathered by clinic personnel using standardized data definitions and transmitted to the principal investigator for analysis.

Goals and Objectives
The goal of the CAP is to improve patient outcomes. The objectives are to provide valid and reliable assessments of current clinical practices to identify opportunities to modify physician behavior and clinical practices through focused education and other interventions, and to establish a baseline for monitoring the effectiveness of interventions on processes of care. The project resulted in a rich and robust clinical database that will facilitate research, meet or exceed AOA and other accreditation requirements and promote public goodwill through voluntary participation in national efforts to improve patient outcomes (e.g., Healthy People 2010). Comparative data from the National Committee for Quality Assurance’s HEDIS program are supplied where available.

Results
These eleven family practice residency programs submitted data for four clinical conditions from 1541 patient records. At the time the study was conducted, 94 residents were in training in these programs. Eight programs participated in the diabetes study and five each participated in women’s health, childhood immunizations and OMM assessments. The largest number of records submitted were for the women’s health study (626) followed by OMM (404), diabetes (371) and childhood immunizations (140).

Conclusions

1. Rates of performance on many of the measures reported here exceed similar rates reported by HEDIS.
2. Variation was noted between residency programs; opportunities for improvement do exist.
3. The CAP program has demonstrated the ability to collect consistent data from multiple clinical programs and provide information regarding performance back to those programs.