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Brief ReportPolicy Brief

Family Physician Participation in Quality Improvement

Lars E. Peterson, Carlos Roberto Jaén and Robert L. Phillips
The Journal of the American Board of Family Medicine November 2013, 26 (6) 626-627; DOI: https://doi.org/10.3122/jabfm.2013.06.120311
Lars E. Peterson
From the American Board of Family Medicine, Lexington, KY (LEP, RLP); and the Departments of Family and Community Medicine and Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, Research to Advance Community Health (ReACH) Center, San Antonio, TX (CRJ).
MD, PhD
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Carlos Roberto Jaén
From the American Board of Family Medicine, Lexington, KY (LEP, RLP); and the Departments of Family and Community Medicine and Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, Research to Advance Community Health (ReACH) Center, San Antonio, TX (CRJ).
MD, PhD
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Robert L. Phillips
From the American Board of Family Medicine, Lexington, KY (LEP, RLP); and the Departments of Family and Community Medicine and Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, Research to Advance Community Health (ReACH) Center, San Antonio, TX (CRJ).
MD, MSPH
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Abstract

More than one-third of family physicians reported participating in a quality improvement (QI) activity in the past year. Continuous QI is vital to improving personal and population health outcomes and reducing costs. Support for QI activities, their evaluation, and the dissemination of successful efforts are sorely needed.

Measurement and reporting of the quality of care physicians deliver is becoming increasingly important.1,2 Payment bonuses or penalties often are tied to the quality of care delivered. Family physicians participating in the American Board of Family Medicine's (ABFM) Maintenance of Certification for Family Physicians (MC-FP) are required to complete a quality improvement (QI) project every 3 years, but they can meet this requirement through other avenues or can perform QI more often. While training in QI is associated with performing QI in practice,3 the prevalence of QI activities among family physicians remains unknown.

We used data from a convenience sample of all family physicians that accessed their physician portfolio on the ABFM website during a 2-week period in September and October 2011. These physicians completed a brief survey that included the question: “In the last year, have you personally participated in a Quality Improvement Project or PDSA [Plan Do Study Act]?” We used this question to represent participation in a QI activity.

During this 2-week period, 5818 family physicians residing in the 50 United States completed the survey (Table 1). The respondents were slightly younger and more likely to be female, be board certified, and to have completed more MC-FP activities than other physicians in the ABFM database. Of the respondents, 38% reported participating in a QI activity in the past year. Part 4 of MC-FP can be met by performing a QI activity, so it is not surprising that physicians who reported QI participation completed more MC-FP activities, and specifically were more likely to have completed a Part 4 module, than those who did not participate in a QI activity. There was no difference in QI participation between rural and urban physicians or by degree type.

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Table 1. Family Physicians Participation in a Quality Improvement (QI) Activity in the Past Year

In a small convenience sample, 38% of family physicians reported some involvement in QI in the past year. Since we assessed only QI participation in the past year, overall involvement in QI projects may be higher than reported here. Continuously improving the quality of health care through QI activities is becoming increasingly important since new health care delivery and payment models are tied to the quality of care provided. Through Part 4 of MC-FP, physicians can increase their knowledge and use of QI; however, further practice redesign, with concomitant increases in payments to support these changes, is needed to advance the triple aim of better health, higher quality, and lower costs.4

Notes

  • This article was externally peer reviewed.

  • Funding: none.

  • Conflict of interest: none declared.

  • See Related Commentary on Page 620.

  • Received for publication November 21, 2012.
  • Revision received May 14, 2013.
  • Accepted for publication May 23, 2013.

References

  1. 1.↵
    1. Rosenthal MB,
    2. Fernandopulle R,
    3. Song HR,
    4. Landon B
    . Paying for quality: providers' incentives for quality improvement. Health Aff (Millwood) 2004;23:127–41.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Mayes R
    . Moving (realistically) from volume-based to value-based health care payment in the USA: starting with Medicare payment policy. J Health Serv Res Policy 2011;16:249–51.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    1. Diaz VA,
    2. Carek PJ,
    3. Johnson SP
    . Impact of quality improvement training during residency on current practice. Fam Med 2012;44:569–73.
    OpenUrlPubMed
  4. 4.↵
    1. Berwick DM,
    2. Nolan TW,
    3. Whittington J
    . The triple aim: care, health and cost. Health Aff (Millwood) 2008;27:759–69.
    OpenUrlAbstract/FREE Full Text
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The Journal of the American Board of Family     Medicine: 26 (6)
The Journal of the American Board of Family Medicine
Vol. 26, Issue 6
November-December 2013
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Family Physician Participation in Quality Improvement
Lars E. Peterson, Carlos Roberto Jaén, Robert L. Phillips
The Journal of the American Board of Family Medicine Nov 2013, 26 (6) 626-627; DOI: 10.3122/jabfm.2013.06.120311

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Family Physician Participation in Quality Improvement
Lars E. Peterson, Carlos Roberto Jaén, Robert L. Phillips
The Journal of the American Board of Family Medicine Nov 2013, 26 (6) 626-627; DOI: 10.3122/jabfm.2013.06.120311
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