Open Access. Powered by Scholars. Published by Universities.®

Family Medicine Commons

Open Access. Powered by Scholars. Published by Universities.®

Quality Improvement

2023

Institution
Keyword
Publication
Publication Type
File Type

Articles 1 - 19 of 19

Full-Text Articles in Family Medicine

The Impact Of Telehealth In Urgent Care Settings, Annie Dong Nov 2023

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.


Enhancing The Rates Of Advance Directive Documentation To Improve The Quality Of Patient Care, Sydney Sheppard, Katie Salyers, Carolyn Curtis, Adam Franks Franks, Courtney Wellman Oct 2023

Enhancing The Rates Of Advance Directive Documentation To Improve The Quality Of Patient Care, Sydney Sheppard, Katie Salyers, Carolyn Curtis, Adam Franks Franks, Courtney Wellman

Marshall Journal of Medicine

Introduction

Advance Directives (AD) allow patients to maintain autonomy during incapacitation. Patients and their caregivers benefit from these documents in times of crisis. Overcoming barriers to AD completion and documentation can improve patient care quality.

Methods

A retrospective chart review was performed initially, after consolidation of the electronic health record (EHR) and after alteration of the EHR, to evaluate the availability of a patient’s medical power of attorney (MPOA), living will (LW), and code status.

Results

Baseline documentation of MPOA (7.33%), LW (6.00%), and code status (5.33%) within the outpatient EHR was low. After 2 cycles, this improved to 13.10%, …


Use Of Electronic Health Record Reminders To Improve Primary Care Providers’ Colorectal Cancer Screening Recommendations., Terra Renee Schrembs Aug 2023

Use Of Electronic Health Record Reminders To Improve Primary Care Providers’ Colorectal Cancer Screening Recommendations., Terra Renee Schrembs

Doctor of Nursing Practice Papers

Background: Colorectal cancer (CRC) is the third most common worldwide cause of cancer morbidity and mortality. CRC mortality is preventable through regular screening. Electronic health record (EHR) reminders for providers can increase providers’ CRC screening recommendations and lead to earlier CRC diagnosis. According to the National Cancer Institute’s Screening and Risk Factors Report for Kentucky by County 2008-2010, 62.7% of adults in a rural Kentucky county aged 50-75 had completed a home based FOBT in the past two years or have ever had a colorectal endoscopy.

Purpose: The purpose of this DNP project was to implement and evaluate an …


Implementing Obesity Management Guidelines In Rural Primary Care, Taylor Bell Jul 2023

Implementing Obesity Management Guidelines In Rural Primary Care, Taylor Bell

Dissertations

Abstract

Problem: In the United States, obesity is one of the leading causes of death among Americans and rates of obesity continue to rise. Geographic location significantly affects the number of obesity cases, with rural areas being affected more than other locations. Despite this, obesity continues to be undertreated by rural primary care providers.

Method: This quality improvement (QI) pilot project utilized a descriptive, observational design to evaluate the implementation of an evidence-based clinical practice guideline algorithm for obesity management in a rural primary care clinic. An algorithm was implemented on patients aged 18-60 years and with a BMI of …


Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp Jul 2023

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …


Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman May 2023

Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman

Doctor of Nursing Practice Projects

In Illinois, the do-not-resuscitate (DNR) form that is legally binding in all healthcare facilities is known as the Practitioner Orders for Life-Sustaining Treatment (POLST) form. The Patient Self-Determination Act (PSDA) of 1991 mandates only certain facilities to discuss advanced care planning (ACP). Primary care offices are not included in this mandate. Therefore, no structured process exists for primary care providers to identify patients who may benefit from ACP discussions. The purpose of this Doctor of Nursing Practice (DNP) project was to initiate conversations about ACP with patients 55 years and older in a primary care office and complete POLST forms …


The Effectiveness Of Examination Table Cleaning Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A. Patrizio, Thomas Boyle, Todd Schachter May 2023

The Effectiveness Of Examination Table Cleaning Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A. Patrizio, Thomas Boyle, Todd Schachter

Rowan-Virtua Research Day

Contaminated environmental surfaces are responsible for acquisition of healthcare associated infections. In 2002 there were approximately 1.7 million healthcare associated infections, resulting in about 99,000 annual deaths. Appropriate disinfection of environmentally contaminated surfaces are required to reduce transmission of pathogens. Adenosine triphosphate (ATP) bioluminescence is being used in hospital settings to audit the cleanliness in the hospital settings. However, there is a paucity of literature in different healthcare settings outside of hospital settings. This may unintentionally result in a more relaxed cleaning protocol in outpatient settings.

Objective: To assess the effectiveness of disinfecting protocol in osteopathic family medicine offices using …


Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski May 2023

Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski

Rowan-Virtua Research Day

Recent guidance suggests the management of screen-detected diabetes can be optimized using multifactorial interventions to improve overall disease burden, patient outcomes, and cost-savings. We explored preventive diabetic care and implemented interventions to increase recommended testing compliance among patients with Type II Diabetes Mellitus. This study employed a multi-faceted approach beginning with the distribution of surveys to patients in the Stratford Family Medicine Office in order to gauge their health literacy level pertaining to Diabetes management. Patient electronic medical records were evaluated to determine baseline levels for all laboratory values. Data analysis was completed using Statistical Package for the Social Sciences …


Improving Diabetic Retinopathy Screening Practices With Qi Methodology In Family Medicine Offices, Rea Isaac, Anne Jones May 2023

Improving Diabetic Retinopathy Screening Practices With Qi Methodology In Family Medicine Offices, Rea Isaac, Anne Jones

Rowan-Virtua Research Day

Early detection and treatment of diabetic retinopathy (DR) is crucial in preventing vision loss and blindness in vulnerable diabetics. With around 7.7 million patients having DR, and the target population being 20 -75 years old, the potential for improving their quality of life is substantial (WHO, 2022). Despite the importance of timely and routine eye exams, 45% of diabetic patients do not complete an exam despite physicians recommendations (Lu, 2014). This project aims to standardize eye exams, improve process flow, and improve patient understanding of the urgency of timely and comprehensive eye exams for DR. Multiple PDSA cycles and QI …


Does Brief Intervention In The Form Of A Lecture Improve Resident Knowledge About Hep C Screening?, Mary Dacosta, Evelyn Chicas, Kiana Clem, Shelby Collymore Apr 2023

Does Brief Intervention In The Form Of A Lecture Improve Resident Knowledge About Hep C Screening?, Mary Dacosta, Evelyn Chicas, Kiana Clem, Shelby Collymore

North Texas GME Research Forum 2023

The prevalence for hepatitis C during 2013-2016 was about ~2.4 million. Screening helps to prevent chronic hepatitis C or start early curative treatment. USPSTF recently changed their guidelines in 2021 for Hepatitis C screening to now include all asymptomatic patients from ages from 18-79 years old without liver disease. Screening usually includes the Hepatitis C Antibody test. Further testing includes Hepatitis C mRNA PCR if screening test is positive. High risk patients should have periodic screening. Since the change, this project was done to ensure the appropriate screening and testing thereafter was done, as well as appropriate communication and documentation. …


Phq -9 Utilization In The Primary Care Setting, Michael Armstrong, Ramisa Rahman, Ceferino Cruz Iv, Afsha Rais Kaisani Apr 2023

Phq -9 Utilization In The Primary Care Setting, Michael Armstrong, Ramisa Rahman, Ceferino Cruz Iv, Afsha Rais Kaisani

North Texas GME Research Forum 2023

INTRODUCTION: The Patient Health Questionnaire-9 (PHQ-9) is a tool used to help diagnose depression and assess a patient’s response to treatment. Quality metric (QM) 371 is a measure of PHQ-9 utilization in patients with depression, and Medical City Family Medicine tracks QM 371 in order to improve the quality of care provided to our patients. This project sought to assess utilization of the PHQ-9 in our clinical practice. At the time of this QI project’s inception, QM 371 was reporting at 0%.

METHODS: Our intervention was to give an educational presentation regarding depression, the PHQ-9, as well as how to …


Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse Mar 2023

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 …


Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries Jan 2023

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …


Continuity Of Care In Rural Surgical Patients, Sydney M. Cardozo Jan 2023

Continuity Of Care In Rural Surgical Patients, Sydney M. Cardozo

Family Medicine Clerkship Student Projects

Continuity of care is an integral part of patient care and is important for reducing morbidity and mortality following hospitalizations. Medical errors are common during transitions of care, and are most frequently caused by lack of suitable discharge planning and poor communication between surgical teams, patients, and primary care physicians. This project aims to create a new standardized note template for surgery teams to use when discharging patients, with the goal of augmenting communication and efficiency during transitions of care within and outside the UVM Health Network.


Prioritizing And Prescribing Exercise: Use Of A Simple Tool To Encourage Clinical Conversations Around Exercise In Family Medicine Out-Patient Clinic, Michael Ladd, Parisa Biazar, Ting Han, Jennifer Horawski, Lisa Wright, Anthony Shadiack Jan 2023

Prioritizing And Prescribing Exercise: Use Of A Simple Tool To Encourage Clinical Conversations Around Exercise In Family Medicine Out-Patient Clinic, Michael Ladd, Parisa Biazar, Ting Han, Jennifer Horawski, Lisa Wright, Anthony Shadiack

South Atlantic Division GME Research Day 2023

No abstract provided.


Qi Project: Increasing Appropriate Use Of Osteopathic Manipulative Treatment As An Adjunctive Treatment For Patients With Musculoskeletal Pain In The Outpatient Setting, Zhe Liu, Aelius Khan, Derek Pride, Thomas Krajewski, Anthony Shadiack Jan 2023

Qi Project: Increasing Appropriate Use Of Osteopathic Manipulative Treatment As An Adjunctive Treatment For Patients With Musculoskeletal Pain In The Outpatient Setting, Zhe Liu, Aelius Khan, Derek Pride, Thomas Krajewski, Anthony Shadiack

South Atlantic Division GME Research Day 2023

No abstract provided.


From Distress To Destress: Screening For Anxiety At Federally Qualified Health Center, Megan Flaviano, John Do, Angelina Rodriguez, Darren Rahaman, Jeremy Sporrong, Ashwitha Francis Jan 2023

From Distress To Destress: Screening For Anxiety At Federally Qualified Health Center, Megan Flaviano, John Do, Angelina Rodriguez, Darren Rahaman, Jeremy Sporrong, Ashwitha Francis

Far West Division GME Research Day 2023

No abstract provided.


Quality Improvement Initiative To Increase Skin Cancer Screenings Among Primary Care Physicians, Aleksandra Radzio, Navina Delight, Scott Lang Jan 2023

Quality Improvement Initiative To Increase Skin Cancer Screenings Among Primary Care Physicians, Aleksandra Radzio, Navina Delight, Scott Lang

North Florida Division GME Research Day 2023

No abstract provided.


Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson Jan 2023

Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson

Doctor of Nursing Practice (DNP) Projects

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …