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Chiropractic Research Review

Improving Patient Outcomes by Improving Quality of Care

This article discusses strategy changes toward quality improvement in chiropractic and multidisciplinary clinical settings. The authors suggest that attention to various goals may help improve patient outcomes, including: reducing unnecessary testing; eliminating ineffective or harmful practices; preventing care dependence; and enhancing patient coping skills.

The authors also discuss quality improvement strategies as implemented successfully at three different chiropractic delivery settings, including two teaching clinics (in California and Iowa) and one large multidisciplinary spine center (in Texas).

This project was part of the Institute for Healthcare Improvement (IHI) collaborative, consisting of experts in the field of low back pain. The IHI collaborative reviewed the "best practices" and identified opportunities to make improvements in providing care to back pain sufferers.

Each health care group involved in the IHI collaborative identified a specific aim for improvement at their respective clinics and then applied incremental changes to improve their health care strategies. Examples of project aims included:

* refining and improving compliance with radiographic guidelines;

* reducing variation among clinicians in the diagnostic assessment of acute low back pain; and

* increasing the percentage of patients adjusted on their first visit to the clinic.

Each clinic was able to reach its goals, implementing change processes and demonstrating outcomes improvements. This study suggests that the strategy of the incremental change process can provide measurable and substantial improvements in a chiropractic clinic.

Mootz RD, Hansen DT, Souza TA, et al. Application of incremental change strategies in chiropractic and multidisciplinary clinical settings for quality improvement. Quality Management in Health Care 2000:8(3), pp42-64.

Chiropractic Research Review

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