Quality Improvement Project


Persson, Lindström, and Lingfors (2000) aimed at studying the possibility of using a computerized journal for quality improvement in the care of diabetes. The study acknowledged that are there different and numerous possibilities for increasing quality improvement with the application of computerized journal. Smoking was identified as a critical risk factor for cardiovascular disease, and the risk is exemplified if the patient in question is diabetic. A smoking diabetic patient is better served to promote their health if they are helped to cease smoking. The study acknowledges that there are different studies on smoking cessation among diabetics and they all have pessimist results. The study aimed at unveiling a smoking cessation program for diabetics using a computerized journal. 

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The Performance Improvement Model

The study was conducted in Habo, a community in southern Sweden with a population of about 9600 people and most of them in the rural setting. The community has members with type II and type I diabetes that the community takes care of using the primary health care. The study settled on reducing the prevalence of smoking among such patients by 30%. To do this, the journals of these diabetic patients were taken through a process of identification and cross-checking to register smoking habits. The study used the BMS and IBM computer systems and registered diabetic patients and all smokers. 147 patients were enrolled in the study; all aged 30-75 years. All the registered patients were invited to join a smoking cessation group. Each invitation was signed by a doctor responsible for the patient and two nurses, one with experience in smoking cessation and the other with experience in diabetes. The study used a group model for smoking cessation. The Swedish Institute for People’s health further recommended the model. 

The process Applied

Two weeks after invitations were sent, a follow-up call was made. Smoking cessation was a free service. The nicotine replacement therapy was availed free by a pharmaceutical company during the first 3 months. A follow up on the patients was done for 18 months and patients were asked of their smoking habits. A patient was considered a non-smoker after maintaining one month without smoking. 

The study found that out of the 147 subjects, 16 had no registration for smoking habits and 25 were smokers. The group met for 13 occasions. For those who were in the smoking cessation group, they had a smoking average time of 35 years. Nine subjects out of the twenty-five smokers became non-smokers after 18 months, which was a 64% success rate. The subjects who also left the group also quit smoking, which indicates a stronger result.


The study demonstrated that computerized journals can be used for a preventative action, especially with a selected patient group. By doing this, the use of available resources gives impetus to such projects. For instance, this project used existing local expertise from doctors and nurses. The study demonstrated optimism, especially with a conversion rate of 64% of chronic smokers who had held on to the habit for more than 35 years. To confirm the efficacy of the study, a more detailed study with more participants need to be conducted. The study confirmed no known study had used the model it adopted it. 

ReferencesPersson, L. G., Lindström, K., & Lingfors, H. (2000). Quality improvement in primary health care using computerised journal, exemplified by a smoking cessation programme for diabetic patients. Scandinavian journal of primary health care, 18(4), 252-253.

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