In the current atmosphere of closer scrutiny of healthcare practices and procedures, front-line managers and health care providers must investigate potential problems in their work environment, whether at the behest of upper management, in order to meet Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards, or through their own sense that “weÆre doing something wrong.” For the investigator with limited previous experience in evaluation or research, the prospect of undertaking this kind of investigation can appear daunting, to say the least. Quality Improvement Projects in Health Care was written just for this individual. Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out “nuts-and-bolts” quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations. Altogether, the cases speak to a broad array of issues and potential pitfalls for the unwary investigatorŭand they show that progress can be made in even the most difficult circumstances. Quality Improvement Projects in Health Care will be of interest to students and professionals in health sciences administration, nursing, allied health, and public health.
Case 12: Use of a Reminder Letter to Encourage Follow-Up Visits1
This case dealt with the problem of patient noncompliance, well known in the literature. A reminder letter solution had already been selected, but the internal consultant attempted to verify the extent of the problem and other risk factors before evaluating the success of the intervention.
Proving the Problem
Lee was a clinical nurse in a medical practice office associated with a major voluntary hospital in New York City. The office was a comprehensive ambulatory care facility specializing in breast cancer. Lee worked in one of four collaborative practices that together treated over 800 women per year. Her office was headed by a surgical oncologist; staff included a ...