Object: To discover how attempts to increase the delivery of preventive services affect clinician satisfaction. Methods: The IMPROVE project was a randomized clinical trial conducted in 44 clinics in and around Minneapolis- St. Paul, Minnesota. Personnel were trained in continuous quality improvement techniques to organize preventive services delivery systems. Satisfaction with delivery of these services and with the sponsoring organizations was measured before the intervention (Time 1), at the end of the intervention (Time 2), and 1 year post-intervention (Time 3). Results: At no time was the intervention associated with a change in the respondents satisfaction with their places of work or with their job roles. Satisfaction with preventive services delivery increased from Time 1 to Time 3 among intervention-clinic respondents. Satisfaction with the IMPROVE project and the efforts of the two managed care organizations to help the clinics deliver preventive services peaked at Time 2 and declined toward baseline at Time 3. Satisfaction with preventive services delivery tended to increase more in the 13 intervention clinics that implemented a preventive services delivery system than in the nine intervention clinics that did not implement a preventive services delivery system (p = 0.15). Conclusions: Planned organizational change to create systems for preventive services delivery can be associated with increased clinician satisfaction with the way these services are delivered. However, increased satisfaction with preventive services does not necessarily indicate that service delivery rates have increased. (C) 2000 American Journal of Preventive Medicine.
Bibliographical noteFunding Information:
T he IMPROVE project was an investigator-initiated, randomized controlled trial funded by a grant from the Agency for Health Care Policy and Research (RO1 HS 08091). 1 Two Minnesota managed care organizations (HealthPartners and Blue Plus), with participation by investigators at the Mayo Clinic, sponsored the project. The project was designed to test the hypothesis that, by promoting an agenda for preventive services and by using continuous quality improvement, managed care organizations can stimulate their private primary care clinics to develop and maintain systems to routinely deliver eight clinical preventive services described in the Healthy People 2000 goals (screening for hypertension, hypercholesterolemia, and tobacco use; screening for breast cancer with clinical breast examination and mammography; screening for cervical cancer with Pap testing; and immunization against influenza and pneumonia). The hypothesis was tested in a volunteer sample of 22 randomly assigned, matched pairs of private primary care clinics that are located in or within 50 miles of the Minneapolis–St. Paul metropolitan area and that have contracts with one or both of the two managed care organizations.
- Clinical trial (randomized controlled trials)
- Health services
- Personal satisfaction
- Preventive health services