The small group consensus process for changing physician practices: influenza vaccination.
OBJECTIVE
To evaluate the effectiveness of a small group consensus process in enhancing compliance with guidelines for influenza vaccination among older HMO members.


METHODS
A controlled study of the practice of primary care physicians, with pre/post comparisons and a 2-year follow-up.


METHODS
An 84,000 member prepaid staff model HMO group practice.


METHODS
Primary care clinicians (N = 36) practicing in a staff model HMO.


METHODS
A small-group process, including opinion leader, feedback, and group decision making.


METHODS
Percentage of patients in a given physician-panel who received influenza immunization.


RESULTS
Improvement in vaccination rate from 60.8% to 72.35% (with further increases over 2 successive years), in the intervention group as compared with improvement in the control from 60.7% to 65.93%.


CONCLUSIONS
In this model, the small group consensus process resulted in an alteration in physician practice pattern, yielding a significant improvement in immunization rates above the already-established level of 60%.
Calkins
E
E
Health Care Plan, Buffalo, NY, USA.
Katz
L A
LA
Karuza
J
J
Wagner
A
A
D000368:Aged; D003245:Consensus Statements as Topic; D003659:Decision Making, Organizational; D006279:Health Maintenance Organizations / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D017146:Models, Organizational; D009518:New York; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'