Quality Improvement Commons^™

Moving Toward Standardization Of Breast Cancer Screening: A Scoping Review Comparing Uspstf And Acs Recommendations For Women Aged 40–74, Gerita F. Perry, Krystal D. Hester-Smith, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose 

To compare U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) breast cancer screening guidelines for women aged 40–74, and to recommend adopting one consistent, standardized guideline in practice. Standardization can improve care continuity, patient adherence, reduce anxiety, support early detection, and lower mortality.

Background 

Breast cancer is the second leading cause of cancer-related death amongst women. The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. The ACS recommends an annual mammogram. Differences between the two organizations for screening emphasize the need for a common alignment to reduce breast cancer mortality. As breast …

Improving The Utilization Of Palliative Care Services At Medical City Fort Worth, Gennipher Smith, Shervin Sarji, Maanasa Palani, Samuel Chen, Mary Halm, Kristina Bowman, Morvarid Rezaie

North Texas GME Research Forum 2026

Palliative Care (PC) is a specialized medical care that aims to optimize the quality of life and alleviate the suffering of patients with serious medical illness. Benefits of palliative care include improved symptom management, enhanced quality of life, reduced healthcare utilization, better care alignment, improved communication and support, and financial savings. Hospital Corporation of America (HCA) Medical City Fort Worth (MCFW) has a PC consult service. However, it is underutilized. According to data collected from January 2025 to December 2025, the percentage of PC consults for high risk units, such as oncology and ICU, by day 3 of admission varies …

Evaluating Referral Rates For Positive Postpartum Depression Screenings At Telehealth And Well-Child Visits: A Scoping Review, Rachel Macklin Barber, Mph, Bsn, Rn, Damaris Amber Brooks, Bsn, Rn, Ashli-Emeria Gary, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn, Kate Fouquier Phd, Aprn, Cnm, Pmh-C, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

Postpartum depression (PPD) affects one in nine women. It has distressing impacts, including behavioral and attachment issues and toveruse of healthcare services. PPD occurs within 4 weeks to 12 months postpartum. A scoping review was conducted to compare referral rates to mental health providers after PPD screenings were conducted via telehealth versus those completed at well-child visits.

Methods

Peer-reviewed articles published within five years before the initial search, beginning September 2022 and ending November 2024, were selected. Articles were sourced from several publications using an online library database with various MeSH terms and Boolean operators. Search results were narrowed …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

Sbirt Workflow, Dory Hart Emery, Tory Gamage, Sara Watts, Carol Mcclure, Anne Barker, Liz Berry, Liz Anderson

Operations Transformation

SBIRT stands for Screening – Identify patients with unhealthy substance use. Brief Intervention – A collaborative conversation that raises a person’s awareness of substance use and its consequences and encourages behavioral changes. Referral to Treatment – Actively link patients to resources when needed. It is a substance use screening tool that we ask patients 18 yrs. old and older to fill out once a year when having their CPE or AWV. SBRIT has been recognized as an integral part of primary care. It is an approach that delivers prevention, detection, and early intervention for individuals at risk of substance use …

Clinician Attitudes And Experiences In Screening Patients For Social Determinants Of Health Using Prapare, Pranav Rane, Mathew B. Weimer M.D., Adam Baus

Journal of Appalachian Health

Introduction: Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. SDOH significantly influence health outcomes; as such, healthcare systems should screen for patients’ social needs. PRAPARE is standardized screening tool designed to assess and address patients’ social needs.

Purpose: This study examines SDOH screening at Valley Health Systems, a federally qualified health center based in Huntington, West Virginia. The aim of this research is to assess clinician attitudes and experiences in using the PRAPARE tool to screen for SDOH.

Methods: A self-administered online survey was conducted from April to May 2022 …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Use Of A Primary Care Dataset To Describe ‘The Real Picture’ Of Diabetes In Kimberley Aboriginal Communities, Caitlyn S. White, Kimberley Seear, Lorraine Anderson, Emma Griffiths

Journal of the Australian Indigenous HealthInfoNet

Objective
Aboriginal communities are impacted by high rates of diabetes, however these are currently underestimated by national data sources used by policy and decision makers to inform allocation of health resources. We aimed to estimate diabetes prevalence and screening coverage using primary care electronic medical record data.

Methods
A cross-sectional audit was conducted using primary care data from Aboriginal regular Aboriginal Community Controlled Health Service (ACCHS) clinic attendees aged 15 years and over (n=1763) in five remote communities in the Kimberley region. Main outcome measures were overall diabetes prevalence; age-specific diabetes prevalence; prevalence of pre-diabetes; and screening rates among patients …

Improving The Screening For Abdominal Aortic Aneurysm At Grand Prairie Internal Medicine Clinic ​, Riddhi H. Patel, Danielle Ford

North Texas GME Research Forum 2024

Introduction: An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. This QI project will involve MCA residents and Grand Prairie clinic attending to incorporate screening for abdominal aortic aneurysm guidelines used by USPSTF and attempt to encourage all our established and new patients who fit into the criteria for …

Screen It Out! Improving Colon Cancer Screening Among Kingwood Clinic Patients, Daniel J. Avila Castillo, Bhavin Patel, Dhruv Patel, Rajeev Raghavan, Zuhair Ali

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Improving The Rates Of Diabetic Screening Exams In A Rural Outpatient Clinic, Sofia Rohde, Mohit Mathavan, Shalaka Venkatraman, David Nguyen, Gino Singer, Shivanie Ramdin, Jennifer Abernathy, Nicholas Dorsey

North Florida Division GME Research Day 2024

No abstract provided.

Implementing A Standardized Screening Algorithm For Iron Deficiency Anemia In Pregnancy, Ariel Moskowitz, Nicole Tenzel, Joshua Mangels, Lyndsay Millican

North Texas GME Research Forum 2024

OBJECTIVE: Anemia in pregnancy is a global health problem and complicates >40% of pregnancies. Anemia is associated with significant maternal and fetal complications including low birth weight, preterm delivery, postpartum hemorrhage, ICU admissions, need for blood transfusion, and maternal morbidity. The American College of Obstetricians and Gynecologists (ACOG) and the CDC recommend screening for anemia at the first prenatal visit and again between 24 and 28 weeks gestation. The aim of this quality improvement project is to improve compliance of screening for anemia in pregnancy amongst the providers of Medical City Women's Care. METHODS: Using the Plan-Do-Study-Act (PDSA) quality improvement …

Single Question Survey Vs The Ongoing Violence Assessment Tool For Intimate Partner Violence Screening In The Ed, Zhengqiu Zhou, Donna Carden, Mariel Michaels, Gretchen Nonawzki, Saria Slowey, Maureen Mohan, Robyn Hoelle

North Florida Division GME Research Day 2024

No abstract provided.

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Geriatric Emergency Medicine Fellowship Journal Club: Operational Changes For Recognizing Prevalent Delirium And Preventing Incident Delirium, Natalie M. Elder

Journal of Geriatric Emergency Medicine

N/A

Using The 4m Model To Screen Geriatric Patients In The Emergency Department, Martinus Megalla, Roopa Avula, Christopher Manners, Portia Chinnery, Lindsey Perrella, Douglas Finefrock

Journal of Geriatric Emergency Medicine

Several models of specialized geriatric care in the Emergency Department (ED) have been developed since the American College of Emergency Physicians (ACEP) began accrediting geriatric EDs in 2018. There is considerable variability in terms of both design and efficacy in regard to screening older patients in the ED and determining proper interventions The John A. Hartford Foundation and Institute for Healthcare Improvement (IHI) have developed the 4M Model for Creating Age-Friendly Health Systems which aims to provide high quality care to older patients by addressing four critical elements: Mentation, Mobility, Medication, What Matters. This article describes a screening tool for …

Preventing Complications Of Undiagnosed Diabetic Peripheral Neuropathy In Rural Healthcare Settings, Kendra Ward Harris

Doctor of Nursing Practice Projects

Background: Diabetic peripheral neuropathy (DPN) affects the lives of approximately 50% of all persons diagnosed with diabetes. Patients who are minorities, residents of rural communities, low income, or non-compliant with treatment, have a higher risk of developing DPN. The long-term effects interfere with the patient’s abilities to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.

Purpose: The purpose of this project was to use the Michigan Neuropathy Screening Instrument (MNSI) …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

Start Stop-Bang, Valerie D. Reeve

MSN Capstone Projects

Currently standard of care in the perioperative unit is not conducive when caring for patients with obstructive sleep apnea (OSA). OSA is highly prevalent and often undiagnosed. Screening patients with a STOP-Bang questionnaire is quick, effective, and cost efficient. OSA is linked to poor postoperative outcomes. Patients at high risk for OSA often encounter complications such as: additional airway management, respiratory complications, cardiovascular complications, and increased length of stay. Screening creates awareness and identification of patients at risk for postoperative complications.