The following quality reports show Clinic patient care performance and outcomes data. Updated annually, they reflect Dreyer's ongoing leadership and achievements in clinical excellence initiatives.

Asthma Action Plans
Breast Cancer Screening
Cervical Cancer Screening
Childhood Immunization
Childhood Pneumococcal Conjugate Vaccine
Coronary Artery Disease Care
Coronary Artery Disease - Depression Screening
Diabetes Management: Eye Exams
Diabetes Management: HbA1c
Diabetes Management: LDL Cholesterol Under 130
Diabetes Nephropathy Screening
Diabetes Depression Screening
Generic Drug Usage
Heart Attack Treatment
Influenza Vaccinations
Smoking Cessation Counseling

The charts show how Dreyer Medical Clinic performed against regional and national goals and the Advocate Health Care physicians network. The Dreyer rates reflect clinical assessment on a pre-selected sample size from Blue Cross Blue Shield of Illinois. The sources of the figures were the following:

• HMO Illinois (HMOI) is a large and well-established health maintenance organization administered by Blue Cross Blue Shield of Illinois, offering managed health care in which a primary care physician coordinates the care of the patient. The HMOI network includes all the providers contracted with HMOI. HMOI gives each medical group comparison data on how each individual group does on quality measures compared to the overall network (all providers).
• Advocate Health Partners (AHP) is the care management and managed care contracting joint venture between Advocate Health Care and select physicians. The physician network includes 2,700 physicians - 2,100 independent physicians in community-based practice and 600 employed physicians in multi-specialty group practices and Advocate Health Care's 8 hospitals. Using a new model of health care delivery, AHP is focused on improving health care quality and outcomes, while reducing the overall cost of care, in both the inpatient and ambulatory settings. Its award-winning clinically integrated approach to patient care utilizes best practices in evidence-based medicine, advanced technology, and quality improvement techniques.
• Sponsored by the U.S. Department of Health and Human Services, Healthy People 2010 is a national disease prevention initiative that identifies the most significant preventable threats to health for all Americans, and establishes national goals to reduce these threats.

The purpose of the asthma project is to improve patients' self-management of their asthma by increasing the percentage of patients who receive written asthma action plans. Doctors complete written instructions for their patients showing them what they should do when they experience various asthma symptoms.

Early detection saves lives. The purpose of the Breast Cancer Screening Project is to improve the breast cancer screening rate in women 52 to 60 years of age by reminding them to have screening mammograms.

Screening prevents deaths from cervical cancer. The purpose is to improve cervical cancer screening using Pap tests in women 18 to 64 years of age. The graph shows the percent of Dreyer female patients in this age category that received a Pap test within the last three years.

Vaccinations save children's lives. The purpose is to improve immunization rates for children turning two years of age. The graph shows the percent of two-year-olds that completed all the required immunizations by their second birthday. These immunizations include polio, measles/mumps/rubella (MMR), haemophilus influenza B (HiB), hepatitis B (HepB), diphtheria/tetanus/pertussis (DTP), and varicella. The measurements are rigid - being late by one day counts against us.

Although pneumococcal conjugate vaccine (Prevnar) is not part of the required combination of immunizations for children at this time, it is believed to be an important service that all children should receive to help prevent ear infections in children and rare, often fatal, blood poisoning.

This measure is a combination of documentation of LDL cholesterol, smoking status, blood pressure, physical activity, weight, and use of antiplatelet agents/anticoagulants in patients with heart disease. The percent for Dreyer represents those patients that had a complete CAD flow sheet in their ambulatory medical record. Tracking all six measures assists the physician and patient to prevent complications of heart disease.

Depression after a heart attack is common, and depression in this setting predicts that patients will do poorly. Asking about depression is the first step in diagnosis and treatment.

Diabetes is the number one cause of blindness. Early detection and treatment of eye problems prevents patients with diabetes from losing their sight. The graph shows the percent of patients with diabetes that had a dilated eye exam. The rate reflects an opportunity for physicians to further assist patients with diabetes.

Hemoglobin A1c (HbA1c) is a wellness measure for people with diabetes. Having a measurement less than 7 is critical to good health. Getting the measurement is the first step. The diabetes management project seeks to improve the quality of care for patients with diabetes through the use of screening tools. The measurement of a diabetic's HbA1c reflects the patient's average blood sugar control. The measure for Dreyer patients indicates what percent had this laboratory test. Having this test as regularly prescribed by the physician helps the patient know whether their diabetes is under control.

Near normal blood glucose is associated with fewer strokes and heart attacks and lower peripheral vascular disease rates. Patients with diabetes are at risk for developing these heart disease problems. Low-density lipoprotein (LDL) cholesterol, the so-called "bad" cholesterol, is the main source of cholesterol build-up and blockage in the arteries. The graph shows the percent of Dreyer patients with diabetes who had an LDL below 130. People with diabetes and an LDL less than 130 have far fewer heart attacks.

Diabetes is the number one cause of kidney failure. The purpose of nephropathy screening is to measure whether diabetics are being screened for kidney damage with tests that will detect very small amounts of protein. Protein in the urine indicates there is damage to the kidneys. Watching for the earliest signs of kidney disease is desirable, because that's when the problem is most treatable.

Just as in heart attacks, depression in diabetes is common and harmful. Current data indicates the prevalence of depression is much higher in patients with chronic illness. Depression in diabetes is known to increase the incidence of diabetic complications and is associated with poor adherence to a diabetic treatment regime. It has been noted that there is a reduction in the risk of persistent depression among screened individuals compared to those who were not screened. Asking about depression is the first step in diagnosis and treatment.

Generic drugs are equivalent to brand name drugs, except they cost less. Prescribing generic medications for outpatient care when they were clinically appropriate and clinically indicated helped save patients approximately $800,000 in lower co-payments for prescriptions in 2005.

The following three charted medications, given at hospital discharge, can save people from another heart attack: ace-inhibitor, beta blocker, and aspirin.

Along with other Advocate Health Care sites, Dreyer Medical Clinic tracks inpatient management of Acute Myocardial Infarction (AMI), or heart attack. The American Heart Association recommends the use of aspirin, beta-blocker therapy, and an angiotensin-converting enzyme (ACE) inhibitor for patients who've had a heart attack because they play a vital role in helping the patient avoid a relapse. Dreyer monitors the patient's medication treatment and plan of care upon discharge from the hospital.

The charts show the increased use of recommended medications among Dreyer patients who have experienced a heart attack along with the current goal for Advocate.

Flu vaccines for vulnerable people prevent unnecessary deaths. Those who are 65 and older, diabetic, and/or asthmatic are at risk. The graph reflects the percent of patients that were identified as being at high risk for complication from influenza received the vaccination. Although the rate was not studied in 2005, more than 16,000 doses were administered.

Doctors actively encourage patients to stop smoking through education and counseling with educational information and referral to smoking cessation programs. This life-saving advice is repeated every year.