Putting outcomes into practice in physician offices.

Implementing outcomes in physician offices is a challenging area. Unlike hospitals, clinics typically have much fewer support staff and resources, electronic clinical data is difficult to access, and physician resistance may be significant. Yet, accountability for outcomes is coming to physician offices. In all outcome efforts, the key steps for guideline implementation are awareness, agreement, decision to adopt, and commitment to adherence. This article describes outcome management efforts in a 15-clinic medical group in the areas of diabetes, asthma, preventive health, pneumonia, heart failure, and patient satisfaction. Implementation strategies, barriers, impact, and outcome data results are described.