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At Sharp HealthCare in San Diego, California administrators, medical staff, and educators are working collaboratively on a “continuous medical education” project to link continuous quality improvement (CQI), quality assurance (QA), and continuing medical education (CME). The purpose of this project is to change the way physicians define quality health care and use education to impact their competence and performance as clinicians. Given the rapid changes occurring within health care in this country and the failure of many previous attempts to link CME and health care delivery, a new paradigm is needed. Using the model of the Harvard Community Health Plan, the administrative and medical director of CME and four medical staff leaders at Sharp Memorial and Cabrillo hospitals spent several days in Boston learning the process of designing clinical algorithms. Currently four algorithms are being developed by these physicians and the algorithm development groups, assisted by the office of CME. The algorithms include the prevention of deep-vein thrombosis, management of abnormal mammograms, management of the hospitalized acute MI patient, and the management of the obstetric patient who fails to progress during labor. The role of the office of CME and preliminary findings are described, along with a projection of the next steps in the implementation of these algorithms. Participating physicians' attitudes are also examined. |
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