A Clinical Assessment Program to Evaluate the Safety of Patient Care

The American Osteopathic Association’s Clinical Assessment Program (AOACAP) provides a mechanism for osteopathic residency programs to measure and improve their quality of patient care. In CAP, current clinical practices are measured, and then compared, to evidence-based practice guidelines representing state-of-the-art professional standards, such as The National Committee on Quality Assurance (NCQA) Health Plan Employer Data and Information Set (HEDIS), Healthy People 2010 targets, and recommendations from the American Diabetes Association. In this program, data abstracted directly from patients’ medical records are analyzed to determine the residents’ performance as well as the impact and effectiveness of residency program treatment protocols in meeting standards of practice for certain clinical categories of patients. These categories are women’s health, childhood immunizations, adult immunizations, low back pain, hypertension, coronary artery disease, and diabetes mellitus. All osteopathic family practice programs are required to participate in the AOA-CAP program as part of the accreditation process. This information is then used, when necessary, to modify residents’ clinical behavior and teaching programs. Improvement is documented through re-evaluation. Our results thus far support the suggestion of NCQA that significant “quality gaps” exist. By reducing these quality gaps, which, according to NCQA, result in more than 57,000 U.S. deaths annually, patient safety is certainly being advanced. Through a platform of process sharing, the AOA-CAP provides specific information to residency program directors about how to improve the quality of patient care.