Quality Improvement Commons^™

Improving Annual Wellness Visit Documentation In Clinic, Chak Lam Yeung, Gurunath Subramanyam, Krishna Ramesh, Mohammad Nadim, Jasmyne Bowser, John Sturgeon

North Texas Research Forum 2025

Introduction: Medicare beneficiaries who received an annual wellness visit (AWV) were noted to have reduced Medicare spending. Review of Medical City North Hills Internal Medicine Clinic data showed that 44% of eligible patients received an AWV. Improper documentation and coding were the primary reasons eligible AWVs were not accounted for even though they were performed. Majority of incomplete documentation was missing information regarding patient’s functional ability, level of safety, home safety, and activities of daily living. The information is normally obtained from a questionnaire completed by the patient prior to the visit. Questionnaire was noted by residents to be unorganized …

Reconciliaction Ensuring Accurate Home Medication List, Juan Pablo Meruvia Garron, Saud Khan, Akash Patel, Anna Maria Abi Nehme, Jomaris Centeno Girona, Olga Karasik

North Florida Division GME Research Day 2025

No abstract provided.

Improving Skin Cancer Screening In A Fm Residency: Dermatoscope Utilization, Aleksandra Radzio, Navina Delight, Aniruddha Logan

North Florida Division GME Research Day 2025

No abstract provided.

Improving Colon & Rectal Cancer Screening At Medical City North Hills Clinic, Basil Nduma, Sharvani Raguthu, Gurunath Subrahmanyam, John Sturgeon

North Texas Research Forum 2025

Introduction: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths globally. Despite its severity, fewer than half of eligible Americans undergo annual screening. The U.S. Preventive Services Task Force (USPSTF) recommends CRC screening from age 45 to 75, with personalized assessments for those aged 76 to 85. The current CRC screening rate at the Medical City North Hills Internal Medicine Residents’ Clinic is 9.3%, significantly below the target rate of over 66%. Objective: This project aimed to increase the CRC screening rate from 9.3% to over 66% at the Medical City North Hills Internal Medicine Residents Clinic, in …

Never Admit Or Release Without Considering A Naloxone Script (Narcan), Farid Mughni, Mustafa Ibrahim, Dante Janolo, Samuel Ramos, Emma Rivas, Olga Karasik

North Florida Division GME Research Day 2025

No abstract provided.

There’S A Qr Code For That: Trauma Performance Improvement, Patient Safety, And Peer Review, April Miller, Luis Taveras, Elizabeth Kim, Kathy Galt

North Texas Research Forum 2025

In preparation for our facility’s initial ACS verification visit, a Trauma Consultative Site visit in 2021 identified the need for a streamlined process to communicate issues to the Trauma Program that were recognized during patient care. This was especially true on weekends and nights when issues were most likely to occur. A recent literature review revealed implementation of electronic communication tools increased reporting of performance improvement and patient safety (PIPS) events and improved tracking and resolution of events. The authors of that study used a virtual chatroom accessible from cell phone to post PIPS events. One perceived drawback to this …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Increasing Special Pathogen Preparedness At A Frontline Hospital: A Quality Improvement Project, Mckenna Freed, Christa Arguinchona, Barbara Bennett-Wolcott

Articles, Abstracts, and Reports

No abstract provided.

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino

SPARK Symposium Presentations

Project Title: The Impact of High Deductible Health Plans on Mental Health Treatment

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact …

Closing The Communication Gap: A Quality Improvement Approach To Safer Shift Changes And Transfers, Stephanie O'Kresik Jewette, Annette Santiago

East Florida Division GME Research Day 2025

No abstract provided.

Seizure Action Plan, Ian Holt, Sy Jama

East Florida Division GME Research Day 2025

No abstract provided.

Initiation Of Sterile Vaginal Preps Prior To Cesarean Sections: A Quality Improvement Project, Diane Gilbertson, Timothy Kremer, Kimberly Udell

North Texas Research Forum 2025

OBJECTIVE: Research on patients undergoing routine gynecological procedures with a vaginal preparation has demonstrated a significant reduction in post-operative infections by decreasing the burden of vaginal bacteria. Despite this research, as well as evidence that they reduce postpartum endometritis, especially in labor patients or those with ruptured membranes (Lui), vaginal preparations prior to cesarean section are not standard practice. Prior to the initiation of this quality improvement project, no patients delivering at Medical City Arlington received a vaginal preparation prior to a cesarean delivery. The goal of this quality improvement project is to improve clinical care, patient safety, and healthcare …

Assessing The Effectiveness Of A Rapid Response Training Course, Nasima Mehraban, Caroline Brooke, Vivek Punjabi, Veeranna Vibhuti

North Texas Research Forum 2025

Introduction: Rapid response teams are crucial in healthcare settings for managing clinical emergencies. To enhance the preparedness of interns in handling such situations, we developed a rapid response training course. This study aimed to evaluate the course's effectiveness by examining changes in residents' self-reported confidence levels before and after completing the training. Methods: A group of interns participated in five simulated rapid response scenarios. Before the training, participants rated their confidence level on a scale from 1 (not confident in running a rapid response) to 10 (very confident). Following the training, they reassessed their confidence level. Pre- and post-training ratings …

Improving Communication And Follow Up For Incidental Findings From Panscan Imaging, Makenzie Morrissey, Kristen Payne, Randall Rittmann, Chris Robert, Joseph Lim, Danielle Pigneri

North Texas Research Forum 2025

OBJECTIVE: Incidental findings in medical imaging pose a significant challenge in healthcare due to the potential for missed follow-ups, which can lead to adverse outcomes for patients. These findings, which are unrelated to the primary purpose of the imaging study, are increasingly common due to advances in imaging technology and its widespread use. The consequences of missed follow-ups can be severe. For instance, the rate of malignancy in incidental pulmonary nodule id about 5% and follow up fails in 30-70% of cases. This means for every 120 CT chest scans ordered, 1 lung cancer is missed (McWilliams et al., 2013). …

Assessment Of Patient Satisfaction Through The Introduction Of A Post-Procedure Pamphlet In An Outpatient Clinic, Mohammad Rashik, James Aston, Sajid Surve

North Texas Research Forum 2025

This quality improvement project aimed to create a patient pamphlet for the Osteopathic Manipulative Medicine (OMM) clinic at the University of North Texas Health Science Center. The pamphlet provides important post-procedure information for patients who undergo treatments like joint injections, platelet-rich plasma therapy, prolotherapy, hydrodissection, botulinum toxin injection, and nerve blocks. These procedures can lead to potential side effects, some of which patients may not be aware of. To address this, the pamphlet includes information on common symptoms, their causes, recommended next steps, and guidance on when to contact the OMM clinic or visit the Emergency Department. The pamphlet was …

Optimization Of Venous Thromboembolism (Vte) Prophylaxis In Pregnancy And The Postpartum Period, Sereena Jivraj, Isabella Sciacca, Sherrie Dixon, Timothy Kremer

North Texas Research Forum 2025

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolisms (PE) continues to be a leading cause of maternal mortality (MM) in the United States. VTE accounts for roughly 9-10% of all maternal deaths. Other countries have adopted anticoagulation protocols to reduce MM rates, but the US has yet to follow suit. The American College of Obstetricians and Gynecologists (ACOG), the American College of Chest Physicians (CHEST), and the Royal College of Obstetricians and Gynaecologists (RCOG) all vary in their guidelines for thromboembolism prophylaxis. Patients who deliver by Cesarean section (C-section) have higher incidences of MM due …

Bridging Knowledge And Practice: Exploring The Medical City Arlington Internal Medicine Handbook, Laura Montoya, Evangelista Ezenduka, Shivani Agarwal, Mike Nguyen, Fatima Safi, Nikhil Madhav, Dallin Beus, George Yeung, Hayan Kundi

North Texas Research Forum 2025

Internal medicine residents face a wide range of challenging medical conditions during their training and need to be equipped with both the knowledge and flexibility to handle whatever comes their way. As part of a collaborative initiative, we present the Medical City Arlington Internal Medicine Handbook, a practical resource built by residents, for residents. This handbook brings together practical insights, evidence-based practices, and specialized clinical expertise, all with the goal of enhancing the diagnostic and treatment skills of internal medicine practitioners. It covers a broad spectrum of conditions, from common ailments to rare and complex diseases, and provides in-depth management …

Under-Utilization Of Non-Selective Beta-Blocker In Patients With Clinically Significant Portal Hypertension & Esophageal Varices, Sohaib Ahmed, Ana Moraga, Syed Usman Mumtaz, Varun Mehta, Boran Mao, Juan Pablo Meruvia, Amar Mandalia, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.

Breaking The Blockade: A Retrospective Analysis Of Pediatricconstipation In Hospitalized Patients, Yenamala Reddy, Jaicy Pottokaran, Eric K. Shaw, Aimee Behnke, Jean B. Wiggins, Lauren Hebert, Norman Taylor Parks

South Atlantic Division GME Research Day 2025

No abstract provided.

Rx On The Rocks: Prescribing Solutions For Alcohol Use Disorder, Arisa Gonzalez, Laura Botero, Adlin Lawrence, Kenneth Jimenez, Eric Chen, Richard Henriquez, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.