• F Daniel Duffy, Lorna A Lynn, Halyna Didura, Brian Hess, Kelly Caverzagie, Louis Grosso, Rebecca A Lipner, and Eric S Holmboe.
• American Board of Internal Medicine, Philadelphia, PA 19010, USA. dduffy@abim.org
• J Contin Educ Health Prof. 2008 Jan 1;28(1):38-46.

BackgroundQuality measurement and improvement in practice are requirements for Maintenance of Certification by the American Board of Medical Specialties boards and a component of many pay for performance programs.ObjectiveTo describe the development of the American Board of Internal Medicine (ABIM) Practice Improvement Module (PIM) and the average performance of ABIM diplomates who have completed the Preventive Cardiology PIM.DesignObservational study of self-administered practice quality improvement.SettingOffice practices through the United States.ParticipantsA total of 179 cardiologists and general internists completing requirements for ABIM Maintenance of Certification from 2004 through 2005.MeasurementsPhysicians self-audited at least 25 charts to obtain performance measures, patient demographics, and coronary heart disease risk factors. At least 25 patients completed surveys regarding their experience of care in the physician's practice. Physicians completed a self-assessment survey detailing the presence of various practice systems.ResultsThe mean rate for systolic blood pressure control was 48%, for diastolic blood pressure 84%, and for low-density lipoprotein (LDL) cholesterol at goal 65%. Of patients 61% rated the quality of care as excellent and 58% rated the practices excellent at encouraging questions and answering them clearly. More than 85% of patients reported "no problem" obtaining a prescription refill, scheduling an appointment, reaching someone in the practice with a question, or obtaining lab results. Targets for improvement were increasing the rates for LDL cholesterol or systolic blood pressure at goal, improving patients' physical activity, patient education, and accuracy of risk assessment. Improvement strategies included implementing chart forms, patient education, or care management processes.LimitationsPatients and charts were selected by physicians reporting their performance for the purpose of MOC.ConclusionsThe Preventive Cardiology PIM successfully provides a self-assessment of practice performance and provides guidance in helping physicians initiate a cycle of quality improvement in their practices.

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