Feature Article
Promoting Preventive Health Screening Through the Use of a Clinical Reminder Tool: An Accountable Care Organization Quality Improvement Initiative
Crystal Wilkinson,
Jane Dimmitt Champion,
Karen Sabharwal,
Corresponding Author
Crystal Wilkinson
For more information on this article, contact Crystal Wilkinson at [email protected].Search for more papers by this authorJane Dimmitt Champion
Search for more papers by this authorKaren Sabharwal
Search for more papers by this authorCrystal Wilkinson,
Jane Dimmitt Champion,
Karen Sabharwal,
Corresponding Author
Crystal Wilkinson
For more information on this article, contact Crystal Wilkinson at [email protected].Search for more papers by this authorJane Dimmitt Champion
Search for more papers by this authorKaren Sabharwal
Search for more papers by this authorFirst published: 04 September 2013
Abstract
This quality improvement initiative was designed to increase clinical prevention performance rates in 11 Austin Regional Clinic primary care facilities as part of an accountable care initiative. The initiative was conducted between January 2011 and December 2011. The principal interventions included implementation of a care coordinator and care gap summary tool. The care gap summary includes recommended preventive healthcare services and serves as a prompt for healthcare providers. These interventions led to improvement in clinical prevention performance rates as demonstrated by aggregate organizational data. This initiative demonstrates that quality improvement initiatives including care gap summaries, workflow changes, and provider feedback can increase performance rates for clinical preventive services.
References
- American Diabetes Association (ADA). (2011). Standards of medical care in diabetes. Diabetes Care, 34, S11–S61.
- Ayers, C. G., & Griffith, H. M. (2007). Perceived barriers to and facilitators of the implementation of priority clinical preventive services guidelines. American Journal of Managed Care, 13, 150–155.
- Ayers, C. G., & Griffith, H. M. (2008). Consensus guidelines: Improving the delivery of clinical preventive services. Health Care Management Review, 33, 300–307.
- Baker, D. W., Persell, S. D., Khol, A. N., Thompson, J. A, & Kaiser, D. (2011). The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system. American Medical Informatics Association, 18, 805–811. doi:10.1136/amiajnl-2011-000169.
- Ballard, D. J., Nicewander, M. S., Qin, H., Fullerton, C., Winter, F. D., & Couch, C. E. (2007). Improving delivery of clinical preventive services: A multi-year journey. American Journal of Preventive Medicine, 33, 492–497.
- Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thompson, M. A. (1998). Closing the gap between research and practice: An overview of systematic review of interventions to promote the implementation of research findings. British Medical Journal, 317, 465–468.
- Bordley, W. C., Margolis, P. A, Stuart, J., Lannon, C., & Keyes, L. (2001). Improving preventive service delivery through office systems. Pediatrics, 108, e41. doi:10.1542/peds.108.3.e41
- Cohen, D., McDaniel, R. R., Crabtree, B. F., Ruhe, M. C., Weyer, S. M, Tallia, A., et al. (2007). A practice change model for quality improvement in primary care practice. Journal of Healthcare Management, 49, 155–168.
- Commonwealth Fund National Scorecard on U.S. Health System Performance. (2008). Chart 2, receipt of recommended screening and preventive care for adults. Data from Mahato, B., Columbia University analysis of Medical Expenditure Panel Survey. Retrieved March 15, 2013, from www.nationalprioritiespartnership.org/uploadedFiles/NPP/Priorities/2.pdf.
- Davidoff, F., & Batalden, P. (2005). Toward stronger evidence on quality improvement. Draft publication guidelines: The beginning of a consensus project. Quality and Safety in Healthcare, 14, 319–325.
- Dopson, S., Fitzgerald, E. W, Gabay, J., & Lolock, L. (2007). No magic targets: Hanging clinical practice to become evidence based. Health Care Management Review, 27, 35–47.
10.1097/00004010-200207000-00005 Google Scholar
- Ferrante, J. M, Balasubramanian, B. A., Hudson, S. V., & Crabtree, B. F. (2010). Principles of the patient-centered medical home and preventive service delivery. Annals of Family Medicine, 8, 108–116.
- Fleming, B., Silver, A., Ocepek-Welikson, K., & Keller, D. (2004). The relationship between organizational systems and clinical quality in diabetes care. American Journal of Managed Care, 10, 934–944.
- Flocke, S. A., Miller, W. L., & Crabtree, B. F. (2007). Relationships between physician practice style, patient satisfaction and attributes of primary care. Journal of Family Practice, 51, 835–840.
- Holmboe, E., Kim, N., Cohen, S., Curry, M., Elwell, A., Petrillo, M. K., et al. (2005). Primary care physicians, office-based practice, and the meaning of quality improvement. American Journal of Medicine, 118, 917–922.
- Hung, D. Y., Rundall, T. G., Crabtree, B. F., Tallia, A. F., Cohen, D. J., & Halpin, H. (2006). Influence of primary care practice and provider attributes on preventive service delivery. American Journal of Preventive Medicine, 30, 413–422.
- Institute for Health Improvement. Retrieved March 15, 2013, from www.ihi.org/knowledge/Pages/HowtoImprove/default.aspx.
- Jackson, P. L. (2002). A systems approach to delivery clinical preventive services. Pediatric Nursing, 28, 377–381. Retrieved from www.mescape.com/viewarticle/442678.
- Jamtvedt, G., Young, J. M., Kristofferson, D. T., O'Brien, M. A., & Oxman, A. D. (2006). Audit and feedback: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2, CD000259.
- Levi, J., Segal, L., & Juliano, C. (2008). Prevention for a healthier America: Investments in disease prevention yield significant savings. Trust for America's Health.
- Lopez-de-Munain, J., Torcal, J., Lopez, V., & Garay, J. (2001). Prevention in routine general practice: Activity patterns and potential promoting factors. Preventive Medicine, 32, 13–22.
- Maciosek, M. V., Coffield, A. B., Flottemesch, T. J., Edwards, N. M., & Solberg, L. I. (2010). Greater use of preventive services in U.S. healthcare could save lives at little or no cost. Health Affairs, 29, 1656–1660.
- Margolis, P. A, Lannon, C. M., Stuart, J. M., Fried, B. J., Keyes-Elstein, L., & Moore, D. E. (2004). Practice based education to improve delivery systems for prevention in primary care: Randomised trial. British Medical Journal Online First, 328, 388.
- McClellan, M., McKethan, A. N., Lewis, J. L., Roski, J., & Fisher, E. S. (2010). A national strategy to put accountable care into practice. Health Affairs, 29, 982–990.
- Moore, K. D., & Coddington, D. C. 2010. Accountable care the journey begins. Healthcare Financial Management, 64, 57–63.
- National Committee for Quality Assurance (NCQA). (2011). Continuous improvement and the expansion of quality measurement. The State of Healthcare Quality 2011. Retrieved March 15, 2013, from http://www.ncqa.org/tabid/836/default.aspx.
- Ornstein, S., Jenkins, R. G., Nietert, P. J., Feifer, C., Roylance, L. F., Nemeth, L., et al. (2004). A multimethod quality improvement intervention to improve preventive cardiovascular care. A cluster randomized trial. Annals of Internal Medicine, 141, 523–532.
- Public Law 111—148. (2010). Patient protection and affordable care act.
- Schuster, M. A., McGlynn, E. A., & Brook, R. H. (1998). How good is the quality of health care in the United States? Milbank Quarterly, 76, 517–563.
- Scoville Associates. (2009). QI-charts excel add-in. Retrieved March 15, 2013, from http://www.pipproducts.com/.
- Shea, S., Dumouchel, W., & Bahamonde, L. (1996). A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting. Journal of American Medical Informatics Association, 3, 399–409.
- Shojania, K. G., McDonald, K. M., Wachter, R. M., & Owens, D. K. (2004). Closing the quality gap: A critical analysis of quality improvement strategies, volume 1: Series overview and methodology (Technical Review 9). AHRQ publication no. 04–0051–1. Rockville, MD: Agency for Healthcare Research and Quality.
- Singh, M. K., Einstadter, D., & Lawrence, R. (2010). A structured women's preventive health clinic for residents: A quality improvement project designed to meet training needs and improve cervical cancer screening rates. Quality and Safety in Healthcare, 19, e45. doi:10.1136/qshc.2009.033274.
- Solberg, L. I., Kottke, T. E., & Brekke, M. L. (2001). Variation in clinical preventive services. Effective Clinical Practice, 4, 121–126.
- Stone, E. G., Morton, S. C., Hulscher, M. E., Maglione, M. A., Roth, E. A., Grimshaw, J. M., et al. (2002). Interventions that increase use of adult immunization and cancer screening services: A meta-analysis. Annals of Internal Medicine, 136, 641–651.
- Taylor, M. (2010). The ABCs of ACOs. Accountable care organizations unite hospitals and other providers in caring for the community. Trustee, 63, 12–14.
- Taylor-Seehafer, M. A., Tyler, D. O., Murphy-Smith, M., Hitt, J., & Meier, B. (2004). Ensuring quality preventive care: The Texas Department of Health's Put Prevention into Practice Initiative. Journal of Public Health Management and Practice, 10, 94–99.
- Thor, J., Lundberg, J., Ask, J., Olsson, J., Carli, C. Harenstam, K. P., et al. (2007). Statistical process control in healthcare improvement. Quality and Safety Health Care, 16, 387–399.
- U.S. Preventive Services Task Force (USPSTF). (2012). Guide to clinical preventive services. Retrieved March 15, 2013, from www.ahrq/gov/clinic/pocketgd.htm.
- Virani, T., Lemieux-Charles, L., Davis, D. A., & Berta, W. (2009). Sustaining change: Once evidence-based practices are transferred, what then? Healthcare Quarterly, 12, 89–96.
