Using run charts for cardiovascular disease risk assessments in general practice
Susan Wells 1 6 , Natasha Rafter 2 , Kyle Eggleton 3 , Catherine Turner 4 , Ying Huang 1 , Chris Bullen 51 Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, New Zealand
2 Senior Lecturer, Royal College of Surgeons in Ireland
3 Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand
4 Population Health Strategist/Analyst, Northland Primary Health Organisations
5 Director, The National Institute for Health Innovation (NIHI), School of Population Health, University of Auckland, New Zealand
6 Correspondence to: Susan Wells, Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, P.O. Box 92019 Auckland Mail Centre, Auckland, New Zealand. Email: s.wells@auckland.ac.nz
Journal of Primary Health Care 8(2) 172-178 https://doi.org/10.1071/HC15030
Published: 30 June 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Run charts are quality improvement tools.
AIM: To investigate the feasibility and acceptability of run charts displaying weekly cardiovascular disease (CVD) risk assessments in general practice and assess their impact on CVD risk assessments.
METHODS: A controlled non-randomised observational study in nine practices using run charts and nine control practices. We measured the weekly proportion of eligible patients with completed CVD risk assessments for 19 weeks before and after run charts were introduced into intervention practices. A random coefficients model determined changes in CVD risk assessment rates (slope) from pre- to post- intervention by aggregating and comparing intervention and control practices’ mean slopes. We interviewed staff in intervention practices about their use of run charts.
RESULTS: Seven intervention practices used their run chart; six consistently plotting weekly data for >12 weeks and positioning charts in a highly visible place. Staff reported that charts were easy to use, a visual reminder for ongoing team efforts, and useful for measuring progress. There were no significant differences between study groups: the mean difference in pre- to post-run chart slope in the intervention group was 0.03% more CVD risk assessments per week; for the control group the mean difference was 0.07%. The between group difference was 0.04% per week (95% CI: –0.26 to 0.35, P = 0.77).
DISCUSSION: Run charts are feasible in everyday general practice and support team processes. There were no differences in CVD risk assessment between the two groups, likely due to national targets driving performance at the time of the study.
KEYWORDS: Cardiovascular diseases; risk assessment; primary care; run charts; quality improvement
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