Project Solo: an independent practitioner initiative for confidential self-assessment of quality

Incentivized digital outcomes collection

The objective of this study was to assess the feasibility of digital patient satisfaction outcomes collection using the Internet and interactive voice response technology. Patients, health care providers, and industry sponsors were provided with incentives to participate. The participants included the practitioners and patients in medical and surgical practices who used Project Quality Card (patent pending) and the Practice Improvement Program. The study subjects were convenience samples of new and established patients seen between September 1999 and December 2000. There were 3 different pilot projects: QC1, QC2, and QC3. Patients were provided with a 20-minute prepaid phone card as an incentive for completing an interactive voice response call. Patients answered the 9-item visit rating questionnaire used to measure patient satisfaction. Patients responded on a 5-point scale, with 5 being excellent, and responses were totaled in the categories of patient access and physician attributes and in an overall score for the visit. A total of 998 patients from 77 physician offices participated. The activation responses, or percentage of patients using the Quality Cards, ranged from 12.8% in group 2 (QC2) to 26.6% in group 1 (QC1) to 34.8% in group 3 (QC3). This study demonstrates that incentivized digital outcomes collection can be successfully implemented in multisite community-based medical and surgical offices. The use of Project Quality Card (interactive voice response technology) and the Practice Improvement Program provides opportunities for user-friendly, benchmarked, real-time data collection. The percentage of patient activations is linked to provider participation in quality improvement programs. Patient participation is improved as the frequency of contact with a peer-directed database increases.

Community-based outcomes research: the Project Solo experience

One of the critical issues in outcomes research is physician participation. The lack of such participation is one of several factors that have made widespread adoption of outcomes measurement slow to materialize. This article focuses on the 6-year experience of Project Solo, a multi-site community-based outcomes research effort.

Utilizing patient satisfaction data to assess quality improvement in community-based medical practices

Our objective was to quantitatively measure the effect of quality improvement-based intervention on the improvement in patient satisfaction with physicians, office visits. A prospective nonrandomized case-control protocol was used at a multiple-site community-based medical and surgical office practices of members of Project Solo/Physicians Information Exchange. The study subjects were convenience samples of new and return patients seen between July 1996 and July 1997. One group of physicians (control group) surveyed patient satisfaction with office visits on two separate occasions with no intervention between the two occasions, except for seeing their own results after the first survey. A second group of physicians (intervention group) also surveyed patient satisfaction with office visits on two separate occasions, but were provided with a quality improvement poster between surveys. Changes in patient satisfaction between the two surveys were measured. The visit rating questionnaire, a nine-item patient-based questionnaire, was used to measure patient satisfaction; percentage excellent responses in the summary categories of patient access, physician attributes, and overall visit were used. Overall, 6088 patients from 59 physicians' offices participated; 3815 patients from 29 physicians in the control group, and 2273 patients from 30 physicians in the intervention group. The control group demonstrated small and nonsignificant changes in patient satisfaction between the two survey periods (0.6-1.4% increase, P = NS), and the intervention group demonstrated statistically significant improvements in patient satisfaction between the two survey periods (4.2-5.7% increase, P = 0.05-0.001). In addition, the two groups were compared directly using a stratified chi 2 analysis, and the differences were also statistically significant (chi 2 = 3.7-8.3, P = 0.05-0.004). We conclude that the use of a quality improvement-based intervention had a significant positive effect on patient satisfaction with office visits, when compared to a group of physicians who did not use any intervention.

Outcomes research in your office

This article reviews the definition of outcomes research. It explores the reasons that outcomes research should be conducted by practicing physicians in both university and private practice settings. Methods for outcomes research with examples relevant to dermatologists are detailed.