Impact of policies and performance measurement on development of organizational coordinating strategies for chronic care delivery.
Am J Manag Care
; 10(2 Pt 2): 171-80, 2004 Feb.
Article
em En
| MEDLINE
| ID: mdl-15005510
ABSTRACT
OBJECTIVE:
To examine the impact of policy directives and performance feedback on the organization (specifically the coordination) of foot care programs for veterans, as mandated by public law within the Department of Veterans Affairs Health Care System (VA). STUDYDESIGN:
Case study of 10 VA medical centers performing diabetes-related amputations. PATIENTS ANDMETHODS:
Based on expert consensus, we identified 16 recommended foot care delivery coordination strategies. Structured interview protocols developed for primary care, foot care, and surgical providers, as well as administrators, were adapted from a prior study of surgical departments.RESULTS:
Although performance measurement results for foot risk screening and referral were high at all study sites over 2 calendar years (average 85%, range 69% to 92%), the number of coordination strategies implemented by any site was relatively low, averaging only 5.4 or 34% (range 1-12 strategies). No facility had systematically collected data to evaluate whether preventive foot care was provided to patients with high-risk foot conditions, or whether these patients had unmet foot care needs.CONCLUSIONS:
Although foot care policies and data feedback resulted in extremely high rates of adherence to foot-related performance measurement, there remained opportunities for improvement in the development of coordinated, technology-supported, data-driven, patient-centered foot care programs.
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Base de dados:
MEDLINE
Assunto principal:
Política de Saúde
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Limite:
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article