Clinician satisfaction with a preventive services implementation trial - The IMPROVE project

Object: To-discover how attempts to increase the delivery of preventive ser vices affect clinician satisfaction. Methods: The IMPROVE project was a randomized clinical trial conducted in 4 4 clinics in and around Minneapolis-St. Paul, Minnesota. Personnel were tra ined in continuous quality improvement techniques to organize preventive se rvices delivery systems. Satisfaction with delivery of these services and w ith the sponsoring organizations was measured before the intervention (Time 1), at the end of the intervention (Time 2), and 1 year postintervention ( Time 3). Results: At no time was the intervention associated with a change in the re spondents satisfaction with their places of work or with their job roles. S atisfaction with preventive services delivery increased from Time 1 to Time 3 among intervention-clinic respondents. Satisfaction with the IMPROVE pro ject and the efforts of the two managed care organizations to help the clin ics deliver preventive services peaked at Time 2 and declined toward baseli ne at Time 3. Satisfaction with preventive services delivery tended to incr ease more in the 13 intervention clinics that implemented a preventive serv ices delivery system than in the nine intervention clinics that did not imp lement a preventive services delivery system (p = 0.15). Conclusions: Planned organizational change to create systems for preventive services delivery can be associated with increased clinician satisfaction with the way these services are delivered. However, increased satisfaction with preventive services does not necessarily indicate that service deliver y rates have increased.