Practice-based continuing education combined with process improvement methods improves delivery of preventive services to children

Abstract

Question

Does continuing medical education in combination with process improvement methods to implement office systems, increase rates of delivery of preventive care to children?

Study design

Cluster randomised controlled trial.

Main results

Significantly more children enrolled in intervention practices received all four preventive services compared with control practices after 30 months (change in proportion of children receiving all four preventive services: 7% to 34% with intervention vs 9% to 10% with no intervention; 4.6-fold increase with intervention compared with control, 95% CI 1.6 to 13.2, see Table 1).

Table 1 Mean percentage of children receiving preventive services at baseline and 30 months follow up.
	Baseline	At 30 months follow-up	Significance
Preventive service	Intervention 22 practices (%)	Control 22 practices (%)	Intervention 22 practices (%)	Control 22 practices (%)	Ratio of change in prevalence, intervention v control
All 4 services	11	12	34	10	4.6, 95 CI 1.6 to 13.2
Immunisations	66	64	Data presented graphically, no absolute numbers given		No significant difference between groups
Tuberculosis screening	39	36	54	32	$\text{p<0.05}$
Anaemia screening	65	64	79	71	$\text{p<0.05}$
Lead screening	32	29	68	30	$\text{p<0.05}$

Authors’ conclusions

Practice-based continuing medical education in combination with process improvement methods increases the rate of delivery of preventive care services to children.