Self-assessment of practice performance: development of the ABIM Practice Improvement Module (PIM).
BACKGROUND
Quality measurement and improvement in practice are requirements for Maintenance of Certification by the American Board of Medical Specialties boards and a component of many pay for performance programs.


OBJECTIVE
To describe the development of the American Board of Internal Medicine (ABIM) Practice Improvement Module (PIM) and the average performance of ABIM diplomates who have completed the Preventive Cardiology PIM.


METHODS
Observational study of self-administered practice quality improvement.


METHODS
Office practices through the United States.


METHODS
A total of 179 cardiologists and general internists completing requirements for ABIM Maintenance of Certification from 2004 through 2005.


METHODS
Physicians self-audited at least 25 charts to obtain performance measures, patient demographics, and coronary heart disease risk factors. At least 25 patients completed surveys regarding their experience of care in the physician's practice. Physicians completed a self-assessment survey detailing the presence of various practice systems.


RESULTS
The mean rate for systolic blood pressure control was 48%, for diastolic blood pressure 84%, and for low-density lipoprotein (LDL) cholesterol at goal 65%. Of patients 61% rated the quality of care as excellent and 58% rated the practices excellent at encouraging questions and answering them clearly. More than 85% of patients reported "no problem" obtaining a prescription refill, scheduling an appointment, reaching someone in the practice with a question, or obtaining lab results. Targets for improvement were increasing the rates for LDL cholesterol or systolic blood pressure at goal, improving patients' physical activity, patient education, and accuracy of risk assessment. Improvement strategies included implementing chart forms, patient education, or care management processes.


CONCLUSIONS
Patients and charts were selected by physicians reporting their performance for the purpose of MOC.


CONCLUSIONS
The Preventive Cardiology PIM successfully provides a self-assessment of practice performance and provides guidance in helping physicians initiate a cycle of quality improvement in their practices.
Duffy
F Daniel
FD
American Board of Internal Medicine, Philadelphia, PA 19010, USA. dduffy@abim.org
Lynn
Lorna A
LA
Didura
Halyna
H
Hess
Brian
B
Caverzagie
Kelly
K
Grosso
Louis
L
Lipner
Rebecca A
RA
Holmboe
Eric S
ES
D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D012655:Self-Evaluation Programs / Q000379:methods*; D013044:Specialty Boards / Q000592:standards; D014481:United States