IMPROVING GENERAL-PRACTITIONER CLINICAL RECORDS WITH A QUALITY ASSURANCE MINIMAL INTERVENTION

Background. Although good medical records have been associated with go od care, there is considerable room for their improvement in general p ractice. Aim. To improve the quality of general practice medical recor ds at minimal cost. Method A total of 150 randomly sampled general pra ctitioners (GPs) in suburban Brisbane, Australia, were randomized in a controlled trial to receive or not receive an intervention. The inter vention consisted of 6 to 12 one-hour monthly meetings when the pairs of GPs assessed samples of each other's medical records using a 12-ite m instrument. This was developed previously by a process of consensus of general practice teachers. Mean scores of 10 medical records select ed at random from before the intervention started and one year later w ere compared. Results. After the intervention, the increase in the tot al score (for which the maximum possible was 18) for the intervention GPs (from a baseline of 11.5 to 12.3) was not significantly greater th an for the controls (from 11.4 to 11.7). Legibility and being able to determine the doctor's assessment of the consultation were significant ly improved. The post-intervention increase of 1.06 (9.3%) of the tota l scores of the 47% of intervention GPs who complied with the interven tion was significantly greater than that for the controls. Conclusion. The quality assurance activity improved some components of the qualit y of GPs' clinical records. However, the improvement was small, and th e search for activities for Australian GPs that demonstrate an improve ment in the quality of their practice must continue.