 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Mort Soroka, PhD, State College of Optometry, State University of New York, 33 West 42 Street, New York, NY 10036, 212-780-5024, msoroka@sunyopt.edu
Objective: To measure the inter-rater reliability of a vision care plan’s chart audit.
Methods: As part of a Quality Improvement Initiative, a managed vision care PPO undertook an evaluation of its record review process. On-site reviews of offices and audit records of patient records are performed by a national cadre of twenty regional quality assurance reviewers. The charts of 29 patients from three participating optometrists in the vision care plan were independently rated by these examiners, using an audit form that was internally developed.
Results: Records from Group 1, deemed to be 8220;good” records, scored significantly higher than the two other groups and tended to have a smaller standard deviation and more uniformity of reviewers’ scores. Records form Group 3, or “poor” records, tended to have a larger standard deviation and less uniformity of reviewers’ scores. The mean score for patients in Group 1 was 83, in Group 2 was 67, and in Group 3 was 40. The reviewers rated more than eighty percent of all records reviewed similarly. When the charts were analyzed individually, it was found that five charts (17%) received scores from reviewers with standard deviations larger than ten (10.0).
Conclusions: Chart review is merely one segment the quality assurance process. In order to conduct a valid review of medical records one must utilize a reliable rating instrument. The review of medical records has become a standard method for measuring quality of care. Proper documentation and record review should not be reserved to Medicare and Medicaid patients.
Learning Objectives:
Keywords: Quality of Care,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.