Promoting Preventive Health Screening Through the Use of a Clinical Reminder Tool: An Accountable Care Organization Quality Improvement Initiative

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.

[1]  J. López-de-Munain,et al.  Prevention in routine general practice: activity patterns and potential promoting factors. , 2001, Preventive medicine.

[2]  T. Meehan,et al.  Primary care physicians, office-based practice, and the meaning of quality improvement. , 2005, The American journal of medicine.

[3]  William DuMouchel,et al.  A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting. , 1996, Journal of the American Medical Informatics Association : JAMIA.

[4]  B. Meyer,et al.  Ensuring quality preventive care: the Texas Department of Health's Put Prevention into Practice initiative. , 2004, Journal of public health management and practice : JPHMP.

[5]  Dorothy Y. Hung,et al.  Influence of primary care practice and provider attributes on preventive service delivery. , 2006, American journal of preventive medicine.

[6]  Sarah Corley,et al.  A Multimethod Quality Improvement Intervention To Improve Preventive Cardiovascular Care , 2004, Annals of Internal Medicine.

[7]  E. McGlynn,et al.  How good is the quality of health care in the United States? , 1998, The Milbank quarterly.

[8]  Sumant R Ranji,et al.  Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 6: Prevention of Healthcare–Associated Infections) , 2007 .

[9]  D. Coddington,et al.  Accountable care the journey begins. , 2010, Healthcare financial management : journal of the Healthcare Financial Management Association.

[10]  B. Fleming,et al.  The relationship between organizational systems and clinical quality in diabetes care. , 2004, The American journal of managed care.

[11]  D. Ballard,et al.  Improving delivery of clinical preventive services: a multi-year journey. , 2007, American journal of preventive medicine.

[12]  Margaret Maglione,et al.  Interventions That Increase Use of Adult Immunization and Cancer Screening Services , 2002, Annals of Internal Medicine.

[13]  L. Solberg,et al.  Variation in clinical preventive services. , 2001, Effective clinical practice : ECP.

[14]  Andrew D Oxman,et al.  Closing the gap between research and practice : an overview of systematic reviews of interventions to promote the implementation of research findings , 2011 .

[15]  Mats Brommels,et al.  Application of statistical process control in healthcare improvement: systematic review , 2007, Quality and Safety in Health Care.

[16]  P. Margolis,et al.  Practice based education to improve delivery systems for prevention in primary care: randomised trial , 2004, BMJ : British Medical Journal.

[17]  F Davidoff,et al.  Toward stronger evidence on quality improvement. Draft publication guidelines: the beginning of a consensus project , 2005, Quality and Safety in Health Care.

[18]  Kurt C Stange,et al.  A Practice Change Model for Quality Improvement in Primary Care Practice , 2004, Journal of healthcare management / American College of Healthcare Executives.

[19]  Cynthia G. Ayres,et al.  Perceived barriers to and facilitators of the implementation of priority clinical preventive services guidelines. , 2007, The American journal of managed care.

[20]  Y. Jang,et al.  Standards of Medical Care in Diabetes-2010 by the American Diabetes Association: Prevention and Management of Cardiovascular Disease , 2010 .

[21]  Mark McClellan,et al.  A national strategy to put accountable care into practice. , 2010, Health affairs.

[22]  Cynthia G. Ayres,et al.  Consensus guidelines: Improving the delivery of clinical preventive services , 2008, Health care management review.

[23]  S. Flocke,et al.  Relationships between physician practice style, patient satisfaction, and attributes of primary care. , 2002, The Journal of family practice.

[24]  Benjamin F. Crabtree,et al.  Principles of the Patient-Centered Medical Home and Preventive Services Delivery , 2010, The Annals of Family Medicine.

[25]  Whitney Berta,et al.  Sustaining change: once evidence-based practices are transferred, what then? , 2009, Healthcare quarterly.

[26]  Shoshannah A. Pearlman The Patient Protection and Affordable Care Act , 2013, Journal of the American Psychiatric Nurses Association.

[27]  L. Solberg,et al.  Greater use of preventive services in U.S. health care could save lives at little or no cost. , 2010, Health affairs.

[28]  Jane M. Young,et al.  Audit and feedback: effects on professional practice and healthcare outcomes. , 2012, The Cochrane database of systematic reviews.

[29]  P. Smaglik Closing the gap , 2005, Nature.

[30]  V. Basevi Standards of Medical Care in Diabetes—2011 , 2011, Diabetes Care.

[31]  P. Margolis,et al.  Improving preventive service delivery through office systems. , 2001, Pediatrics.

[32]  Abel N. Kho,et al.  The marginal value of pre-visit paper reminders when added to a multifaceted electronic health record based quality improvement system , 2011, J. Am. Medical Informatics Assoc..

[33]  Douglas Einstadter,et al.  A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates , 2010, Quality and Safety in Health Care.