Improved preventive care following an intervention during an ambulatory care rotation: carryover to a second setting.

Recent studies have shown that physician compliance with recommended preventive care guidelines can be improved. Little is known, however, about whether a successful intervention aimed at improving performance applied in one setting will carry over to another. To explore this issue, the authors examined the impact of an intervention involving lecture, feedback, and checklists introduced during an ambulatory care rotation at one hospital (SPR) on resident performance of six preventive care measures at a second outpatient clinic (VA). The performance of 15 residents who had been exposed to the program was compared with that of 13 who had not been exposed to the program. The mean proportion of indicated measures performed by the exposed residents was significantly higher than that of the residents without exposure to the program (0.49 vs. 0.36, p less than 0.05). Improvement was found for all measures but was statistically significant only for influenza vaccination (0.28 vs. 0.07, p = 0.03). Post-intervention performance at SPR was also significantly improved (0.53 vs. 0.36, p less than 0.001). The authors conclude not only that the intervention improved resident performance of preventive care but also that the improvement was carried over to practice in a second outpatient setting.