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Ambulatory Care Quality Improvement (ACQUIP) - Article


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External Quality Assessment



Clinical Trial: Ambulatory Care Quality Improvement (ACQUIP)

This study has been completed.

Sponsored by: Department of Veterans Affairs
Information provided by: Department of Veterans Affairs

Purpose

Health care organizations, including the VA, are investing substantial effort to improve quality of care. As part of this process, greater emphasis is being placed on measurement of outcomes, and in particular, functional outcomes and satisfaction as reported by patients. ACQUIP was designed to determine whether quality and outcomes of health care improve when primary care providers have access to regular assessments of their patients' health and function along with routine clinical data and information about clinical guidelines. This study was a randomized trial conducted at the General Internal Medicine Clinics of seven VA facilities. Each participating GIMC is organized into discrete firms staffed by different groups of providers who care for different patients. One randomly selected firm received the intervention and one served as control. Patients who made at least one GIMC visit in the last year were eligible to participate. Patients were surveyed at baseline to determine active medical problems. Subsequent mailings included a general evaluation of health status (SF-36), a satisfaction questionnaire and, as appropriate, one of six condition-specific questionnaires: the Seattle Angina Questionnaire, the Seattle Obstructive Lung Disease Questionnaire, the Hopkins Symptom Checklist (depression), and questionnaires regarding diabetes, drinking, and hypertension. Clinical/utilization data were downloaded weekly from VISTA and supplemented with data from Austin. The intervention consisted of multi-faceted reports to patients' primary care providers (at the time of patient visits) showing trended physiologic and health status data and guideline-derived recommendations. Clinicians also received periodical reports displaying trends in the health status and satisfaction of their patients compared with their clinic as a whole. Reports were supplemented by training on QI and health status measures.

Condition Treatment or Intervention Phase
Quality of Health Care
health status measures
Outcomes assessment (health care)
continuous quality improvement
 Behavior: Provision of health status information to patients provider
Phase II

MedlinePlus consumer health information 

Study Type: Interventional
Study Design: Educational/Counseling/Training, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study

Further Study Details: 

Expected Total Enrollment:  62487

Study start: April 1996;  Study completion: September 2000

Eligibility

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both

Criteria

Enrolled in VA GIM clinic with visit in past year

Location Information


Arkansas
      Central Arkansas Veterans Healthcare System, No Little Rock,  Arkansas,  72114-1706,  United States

California
      VA Palo Alto Health Care System, Palo Alto,  California,  94304-1207,  United States

      VA Greater Los Angeles Healthcare System, West Los Angeles,  California,  90073,  United States

Vermont
      VA Medical & Regional Office Center, White River Junction,  Vermont,  05009-0001,  United States

Washington
      Seattle Medical Center, Seattle,  Washington,  98108,  United States

      Seattle Medical Center, Seattle,  Washington,  98108,  United States

      University of Washington, Seattle,  Washington,  98195,  United States

      Seattle Medical Center, Seattle,  Washington,  98108,  United States

More Information

Publications

Bradley KA, McDonell MB, Bush K, Kivlahan DR, Diehr P, Fihn SD. The AUDIT alcohol consumption questions: reliability, validity, and responsiveness to change in older male primary care patients. Alcohol Clin Exp Res. 1998 Nov;22(8):1842-9.

Bradley KA, Bush KR, McDonell MB, Malone T, Fihn SD. Screening for problem drinking: comparison of CAGE and AUDIT. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. J Gen Intern Med. 1998 Jun;13(6):379-88.

Henderson WG, Demakis J, Fihn SD, Weinberger M, Oddone E, Deykin D. Cooperative studies in health services research in the Department of Veterans Affairs. Control Clin Trials. 1998 Apr;19(2):134-48. Review.

Henderson WG, Demakis J, Fihn SD, Weinberger M, Oddone E, Deykin D. Design issues in the planning of multi-center cooperative studies in health services research. Controlled Clinical Trials 1998; 19: 134-148.

Spertus JA, McDonell M, Woodman CL, Fihn SD. Association between depression and worse disease-specific functional status in outpatients with coronary artery disease. Am Heart J. 2000 Jul;140(1):105-10.

Study ID Numbers:  SDR 96-002
Record last reviewed:  December 2000
Last Updated:  October 13, 2004
Record first received:  March 14, 2001
ClinicalTrials.gov Identifier:  NCT00013130
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08


Source: ClinicalTrials.gov
Cache Date: April 8, 2005

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November 19, 2008



Page Updated: November 22, 2004
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