Purpose: The purpose of this study was to evaluate compliance with the American Academy of Ophthalmology Diabetic Retinopathy (DR) Preferred Practice Pattern for an initial DR examination in a resident ophthalmology clinic. Methods: Adult patients with diabetes were included if seen in the resident ophthalmology clinic at a Veterans Affairs Medical Center for an initial DR examination between July 2006 and June 2007. Medical records were reviewed for compliance with the 29 applicable elements from the American Academy of Ophthalmology DR Preferred Practice Pattern. Results: Of 451 diabetic patient visits in the ophthalmology clinic in the study period, 70 met inclusion criteria. The overall mean compliance rate was 52%. Compliance was best in the categories of examination (mean = 87%), diagnosis (mean = 82%), and treatment (mean = 74%). Compliance was lowest in the categories of medical history (mean = 11%) and counseling/referral (mean = 34%). Conclusion: Compliance with both practice and documentation of American Academy of Ophthalmology DR Preferred Practice Pattern guidelines at a resident ophthalmology clinic should be monitored, especially in the areas of medical history, patient education, and referrals. A target level of compliance should be set and maintained in all the DR Preferred Practice Pattern categories, especially in a teaching hospital where residents are developing their approach to quality care.
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