Do peer chart audits improve residents' performance in providing preventive care?
OBJECTIVE
One recommended method to evaluate residents' competence in practice-based learning and improvement is chart audit. This study determined whether residents improved in providing preventive care after a peer chart audit program was initiated.


METHODS
Residents audited 1,005 charts and scored their peers on 12 clinical preventive services. The mean total chart audit scores were compared across five time blocks of the 45-month study.


RESULTS
Residents' performance in providing preventive care initially improved significantly but declined in the last ten months. However, their performance remained significantly higher than at the beginning.


CONCLUSIONS
By auditing their peers' charts, residents improved their own performance in providing preventive care. The diffusion of innovations theory may explain the prolonged implementation phase and problems in maintaining a chart audit program.
Paukert
Judy L
JL
The University of Texas Health Science Center, San Antonio 78229-3900, USA. paukert@uthscsa.edu
Chumley-Jones
Heidi S
HS
Littlefield
John H
JH
D000704:Analysis of Variance; D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008485:Medical Audit; D018024:Peer Review, Health Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011315:Preventive Medicine / Q000592:standards*; D014481:United States