Improving delivery of clinical preventive services: a multi-year journey

Am J Prev Med. 2007 Dec;33(6):492-7. doi: 10.1016/j.amepre.2007.07.040.


Background: Adults in the United States typically do not receive all recommended clinical preventive services (CPS) for which they are eligible, missing opportunities for prevention and/or early detection. A multi-year quality improvement initiative targeting CPS delivery in a fee-for-service ambulatory care network is described.

Methods: Since 1999, HealthTexas Provider Network (HTPN) has implemented multiple initiatives to increase CPS delivery, including a flowsheet, a physician champion model, physician- and practice-level audit and feedback, and rapid-cycle quality improvement training.

Results: From 2000 to 2006, "recommended or done" CPS delivery increased from 68% to 92%, and "done" from 70% to 86% (2001 to 2006). "Perfect care" composite performance increased from 0.19 to 0.51 (2001 to 2006).

Conclusions: Long-term, multistrategy approaches can achieve substantial sustained improvement in CPS delivery throughout a large ambulatory care provider network.

MeSH terms

  • Ambulatory Care / organization & administration
  • Ambulatory Care / standards*
  • Community Networks / organization & administration
  • Community Networks / standards
  • Fee-for-Service Plans / organization & administration
  • Fee-for-Service Plans / standards
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / standards*
  • Humans
  • Pilot Projects
  • Preventive Health Services / organization & administration
  • Preventive Health Services / standards*
  • Quality Assurance, Health Care / organization & administration
  • Quality Assurance, Health Care / standards*
  • Quality Indicators, Health Care
  • Texas
  • Time Factors