Abstract
Educational Objectives
| 1. | To familiarize clinicians with the preferred practice patterns as they relate to patients with esotropia. | ||||
| 2. | To highlight the summary benchmarks within the preferred practice patterns for esotropia. | ||||
| 3. | To highlight areas of potential deficiency among compliance with the preferred practice patterns. | ||||
Purpose:
To evaluate documentation of the initial evaluation in patients with esotropia, with respect to history, physical examination, care management, and patient education, for the presence of key elements as defined in the American Academy of Ophthalmology's Summary Benchmarks for Preferred Practice Patterns.
Methods:
Two hundred charts of patients seen at the Pediatrics Service at the Duke Eye Center for an initial diagnosis of esotropia were reviewed relative to both the 2002 (all patients) and 2007 (for those seen in 2007) Preferred Practice Patterns benchmarks for esotropia. Documentation of key elements as defined in the Preferred Practice Patterns was recorded.
Results:
The average total score was 85.8% for all evaluations. On average, 63.6% of the initial history key elements, 99.6% of the initial physical examination key elements, and 94.2% of the care management and patient education key elements were documented. For evaluations performed in 2007 and scored according to the 2007 Preferred Practice Patterns, scores were similar, except that the physical examination subset score average decreased to 90.3% and the family history documentation score increased to 45.5%.
Conclusion:
In an academic practice, the process quality of care for strabismus often conforms well to professional practice patterns. However, there are opportunities for improvement in the documentation of key history elements. Additional data are needed from other practice settings and for other conditions to assess the quality of eye care for children.
[J Pediatr Ophthalmol Strabismus 2010;47:145–149.]
- 1.. The quality of ambulatory care delivered to children in the United States. N Engl J Med. 2007; 357:1515–1523. > Crossref MedlineGoogle Scholar
- 2.. The quality of health care delivered to adults in the United States. N Engl J Med. 2003; 348:2635–2645. > Crossref MedlineGoogle Scholar
- 3.. Understanding the American Academy of Ophthalmology's preferred practice pattern for cataract. Int Ophthalmol Clin. 1998; 38:87–92. > Crossref MedlineGoogle Scholar
- 4.. Patterns of care for open-angle glaucoma in managed care. Arch Ophthalmol. 2003; 121:777–783. > Crossref MedlineGoogle Scholar
- 5.. Longitudinal rates of annual eye examinations of persons with diabetes and chronic eye diseases. Ophthalmology. 2003; 110:1952–1959. > Crossref MedlineGoogle Scholar
- 6.. Patterns of adherence to diabetes vision care guidelines: baseline findings from the Diabetic Retinopathy Awareness Program. Ophthalmology. 2001; 108:563–571. > Crossref MedlineGoogle Scholar
- 7.. Documentation patterns before cataract surgery at ten academic centers. Ophthalmology. 1996; 103:1179–1183. > Crossref MedlineGoogle Scholar
- 8.. Summary Benchmarks for Preferred Practice Pattern® Guidelines. Retrieved December 15, 2007, from http://one.aao.org/asset.axd?id=7b49ad9f-f671-46d4-b49f-b76ff5396290. > Google Scholar
- 9.. Evaluation of practice patterns for the care of open-angle glaucoma compared with claims data: the Glaucoma Adherence and Persistency Study. Ophthalmology. 2007; 114:1599–1606. > Crossref MedlineGoogle Scholar
- 10.. Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA. 2000; 283:1740–1742. > Crossref MedlineGoogle Scholar
- 11.. Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med. 2004; 141:771–780. > Crossref MedlineGoogle Scholar
- 12.. How well does chart abstraction measure quality? A prospective comparison of standardized patients with the medical record. Am J Med. 2000; 108:642–649. > Crossref MedlineGoogle Scholar
