QUALITY IMPROVEMENT IN FAMILY-PRACTICE - PROGRAM FOR PAP SMEARS

PROBLEM BEING ADDRESSED With the increasing emphasis on quality improv ement, we need programs for improving office practice. OBJECTIVE OF PR OGRAM To demonstrate a simple and inexpensive program that resulted in improvement in the quality of Papanicolaou smears in a family practic e teaching clinic. The performance measure was the proportion of smear s containing endocervical components. MAIN COMPONENTS OF PROGRAM The p rogram involved annual feedback on the performance of the physicians i n the clinic. Feedback was given to physicians at a regular group meet ing; brief discussion of the findings also occurred at that time. Ther e were no other interventions. CONCLUSIONS A program involving straigh tforward feedback and discussion for less than 1 hour contributed to a 7% improvement in the proportion of Pap smears with endocervical comp onents. This ''low tech'' approach should be tested in other settings and with other procedures and treatments.