Delivery of Preventive Services in Primary Care (Oklahoma)

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Summary:

The Center for Family Medicine Research at the University of Oklahoma and the Oklahoma Physicians Resource/Research Network, in collaboration with Medical Data Solutions, Inc., (a software development company) studied the effectiveness of a multi-component intervention to translate three office system strategies known to increase delivery of immunizations and other preventive services in a group of primary care practices.  The translational intervention included medical record audits with feedback and benchmarking, academic detailing by a local opinion leader including suggestions derived from peer exemplars (results of "best practices research"), a practice enhancement assistant (practice facilitator), and a computer application designed to help the practice incorporate and maintain the office system strategies.  The strategies of interest included nurse standing orders, a recall and reminder system, and special immunization and preventive services clinics.  Practices were randomized to the multi-component intervention group or to the control group, which receive feedback with benchmarking alone.  The primary outcome measure was the number of office system strategies (of the three) adopted by the practice.  Contextual factors and barriers and their impact on adoption of the office system strategies were analyzed.  Finally, we also compared the rates of delivery of selected immunizations and preventive services to determine the size of the effect of the intervention on preventive services delivery.  This two-year study, though relatively small, contributed to our understanding of multi-component translational interventions within practice-based research networks.

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