Medical College of Wisconsin
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Assessment of Adherence to Baseline Quality Measures for Cirrhosis and the Impact of Performance Feedback in a Regional VA Medical Center. Am J Med Qual 2018 May/Jun;33(3):262-268



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Baseline adherence to cirrhotic quality improvement measures was assessed and a system to improve adherence with provider performance feedback was developed, with impact of feedback measured over time. A 6-year retrospective database was created of cirrhotic patients seen between 2006 and 2012, and reviewed for hepatitis A and B serologies, hepatocellular carcinoma (HCC) screening, variceal screening, and vaccinations. Cumulative performance feedback was distributed to providers. In all, 265 charts were reviewed retrospectively. Charts were reviewed prospectively at 30 days, 60 days, 6 months, and 12 months. Variceal screening, alpha-fetoprotein, HCC imaging, Pneumovax, lifetime influenza vaccination, hepatitis B vaccination, and hepatitis A serology compliance improved from baseline until 6 months. Hepatitis A vaccination declined at 60 days, but improved from baseline at 6 months. Hepatitis B serology improved from baseline over 12 months. Results were compared graphically. Periodic "cumulative provider performance feedback" is a simple and effective method to improve and maintain adherence to quality measures for cirrhosis.

Author List

Cahill JA, Rizvi S, Saeian K


Kia Saeian MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Carcinoma, Hepatocellular
Early Detection of Cancer
Esophageal and Gastric Varices
Guideline Adherence
Hepatitis A
Hepatitis A Vaccines
Hepatitis B
Hepatitis B Vaccines
Liver Cirrhosis
Liver Neoplasms
Practice Guidelines as Topic
Quality Improvement
Quality Indicators, Health Care
Retrospective Studies
United States
United States Department of Veterans Affairs
jenkins-FCD Prod-466 5b81815b8b3d1f46bfec16512ed5f574613f59c5