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The Long-Term Impact of a Performance Improvement Continuing Medical Education Intervention on Osteoporosis Screening

Zisblatt, Lara MA, PMME; Kues, John R. PhD, CCMEP; Davis, Nancy PhD; Willis, Charles E. MBA

Journal of Continuing Education in the Health Professions: Autumn 2013 - Volume 33 - Issue 4 - p 206–214
doi: 10.1002/chp.21200
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Introduction: The purpose of this study is to determine whether a performance improvement continuing medical education (PI CME) initiative that utilizes quality improvement (QI) principles is effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis.

Methodology: A health care center participated in a PI CME program designed to increase appropriate osteoporosis screening. There were eight 1-hour educational sessions for this activity over a 9-month period. Thirteen providers completed all 3 stages of the PI CME program. A variety of other clinicians, in addition to the 13 providers, participated in the educational sessions. Data were collected at the beginning and end of the PI CME activity and at three intervals during the 5 years after the completion of the activity.

Results: The percentage of tests for osteoporosis ordered and performed increased significantly from Stage A to Stage C of the PI CME activity and continued to increase after the completion of the PI CME activity. Follow-up data at 4 and 40 months (for ordering and performing osteoporosis screening) and 49 months (for performing the screening only) reflect the impact of the PI CME activity plus the continuing QI interventions. The percentage of BMD tests ordered continued to increase substantially over the post-PI CME periods: 4 and 40 months (F(3,46) = 4.04, p < .05). Similarly, the percentage of BMD tests performed continued to increase at 4, 40, and 49 months after the conclusion of the PI CME activity (F(4,55) = 12.55, p < .0001).

Discussion: The data indicate that PI CME utilizing QI principles can be effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis. Further research is needed to determine the extent to which such changes can be directly attributed to this type of intervention.

Ms. Zisblatt: Assistant Director, Continuing Medical Education, Boston University School of Medicine; Dr. Kues: Associate Dean for Continuous Professional Development, Professor Emeritus of Family Medicine, University of Cincinnati College of Medicine; Dr. Davis: Director, Practice Based Learning and Improvement, Association of American Medical Colleges; Mr. Willis: Principal, Clinical Outcomes Improvement.

Disclosures: The authors report this CME activity was supported by an educational grant from Proctor & Gamble. Mr. Willis was a consult on a Pfizer Inc. grant review panel

Correspondence: Lara Zisblatt, Continuing Medical Education, Boston University School of Medicine, 72 East Concord Street, A402, Boston, MA 02118; e-mail: laraz@bu.edu or cme@bu.edu.

Published online in Wiley Online Library (wileyonlinelibrary.com).

© 2013 Lippincott Williams & Wilkins, Inc.
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