The impact of a health screening flow sheet on the performance and documentation of health screening procedures.

We monitored physician performance of stool occult blood testing and breast exams during health maintenance visits of patients aged 50 or greater, to assess the impact of a physician education program and the use of a health screening flow sheet on performance of these health screening procedures. During the baseline study period, use of these procedures was documented for only about 40% of patients. A physician education program (conferences reviewing appropriate health maintenance screening procedures, and information on the use of a specific health screening flow sheet) did not significantly change the rate of documented physician performance of these procedures. After a health screening flow sheet was introduced into the medical record, the rate of documented performance of these screening tests increased. However, despite the presence of the screening flow sheet in the patient record, most screening evaluations were documented only in the progress notes. These results suggest that the screening flow sheet serves primarily as a memory prompting device. The usefulness of the flow sheet as a patient data storage device appears questionable.

MMPI identification of nonrehabilitants among disabled veterans.

Utilized the Minnesota Multiphasic Personality Inventory (MMPI) with IQ scores and selected biographic data to identify drop-outs in a Veterans Administration vocational rehabilitation program. Subjects were 61 male disabled veterans. Data were collected at VA Hospital Richmond, Virginia, between September 1973 and September 1974. Follow-up six months after entrance into training utilized persistence in training or employment as success criteria. Multivariate analysis identified 32 of 33 successful and 25 of 28 unsuccessful subjects with p less than .001. Factor analysis of the best predictors identified MMPI Psychopathic deviate (Pd) Hypomania (Ma), and Lie (L) scales which was interpreted to be a social adjustment factor. Four other factors were identified. Results indicated the MMPI was a useful instrument in the identification of disabled veterans who were likely to experience difficulty in post-hospital vocational rehabilitation.