The impact of an organized approach to prevention.

A study was conducted to compare preventive strategies in an urban, southwest Ontario family practice before and after the adoption of a periodic health assessment flow sheet. The flow sheet is similar to one developed by Frame and Carlson; the patient's history, screening procedures, health practices, and individual risk factors can be recorded on it. Approximately one hundred charts of patients between age 20 and 55 were randomly selected for the study. A comparison was made between the first general health assessment made from 1970-1977, before the flow sheet was used, and the first assessment from 1978-1982, when the sheet was used. There were significant differences between the assessments. Before 1978, a cholesterol test was requested for only 15.1% of patients in the study, immunization status was discussed with only 11.3%, and no record was made of their health practices. After 1978, cholesterol tests were requested for 82.2%, immunization status was discussed with 93.3%, and health practices were recorded for 82.2%. It is relatively easy to incorporate the flow sheet into practice, and it can be used to provide consistent preventive care.