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Effective Clinical Practice

November/December 2001


A CQI Intervention To Change the Care of Depression: A Controlled Study
Leif I. Solberg, Lucy Rose Fischer, Feifei Wei, William A. Rush, Kathleen S. Conboy, Thomson F. Davis, and Richard L. Heinrich

Development and implementation of a graded set of five care management options failed to improve treatment for depression. Why? Reasons include: lack of sufficient physician buy-in and an environment that was not conducive to change.
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Caregiver Perceptions of the Reasons for Delayed Hospital Discharge
Tracey M. Minichiello, Andrew D. Auerbach, and Robert M. Wachter

Timely discharge from the hospital is crucial for cost-containment; however, caregivers at the same institutions perceive different barriers to this goal. Improved communication is the most obvious way to reduce unnecessary hospital days.
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Effect of a Self-Mangement Program on Patients with Chronic Disease
Kate R. Lorig, David S. Sobel, Philip L. Ritter, Diana Laurent, and Mary Hobbs

The results of a recent randomized clinical trial demonstrating the potential of self-management to improve health status and reduce health care utilization in patients with chronic diseases were reproduced in a real-world setting.
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A Practice-Based Approach for Converting from Proton Pump Inhibitors to Less Costly Therapy
Linda M. Lucas, Martha S. Gerrity, and Thomas Anderson

Although many people require a proton pump inhibitor (PPI) for control of dyspepsia, symptom control can often be achieved with an H2 blocker. This low-intensity, practice-based intervention was successful in reducing PPI costs by 30%, a reduction that was sustained for three quarters after the conversion process.
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Screening for Diabetes Mellitus in High-Risk Patients: Cost, Yield, and Acceptability
Patrick J. O'Connor, William A. Rush, Linda M. Cherney, and Nicolaas P.

The authors invited patients with high cholesterol and hypertension to participate in a diabetes screening program. In addition to high costs, the program had low acceptability and low yield.
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Quality Improvement Can't Be Optional
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Finding Undiagnosed Type 2 Diabetes: Is it Worth the Effort?
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Type I and Type II Errors
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Thank You to Reviewers
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