Quality and Practice Improvement

Enhancing the delivery of healthcare through quality improvement measures improves the value of care to the patient and patient satisfaction. The department is developing new models of care and evaluating their effectiveness. Faculty in the department are engaged in practice improvement projects related to cervical cancer screening, online care and virtual consultation, and care delivery by mid-level providers and nurse care managers.

A variety of quality improvement initiatives in the Family Medicine department are underway with topics including cervical cancer screening (Dr. Kathy MacLaughlin), inbox usage (Dr. Vicki Jacobsen), access and triage (Dr. Teresa Jensen and Dr. Walt Franz), hospital care focusing on readmissions (Dr. Greg Garrison and the FM residents) and enhancing patient involvement (Mr. Rob Bender).

As part of a multi-disciplinary team sponsored by the Office of Women's Health, Dr. Kathy MacLaughlin had the opportunity to attend Mayo's Quality Academy while working on a cervical cancer screening QI project. The group's goal is to reduce over-utilization of Pap testing and improve compliance with updated screening guidelines. Patient and provider surveys were performed to assess baseline knowledge about Pap tests/HPV, comfort level with updated guidelines and barriers to appropriate screening. On-line and paper tools were created to help providers access updated guidelines. Lectures were given at departmental gatherings and a residency conference. Pre and post-intervention measurement of "too soon" Paps has shown improvement with a decreased rate of over-utilization. Dr. Liz Westby also attended the Quality Academy as part of an integrated prenatal care team project.

A newer pilot project sponsored by ECH is targeting the under-screened population (in terms of Pap testing) and is in the process of evaluating data collected in the first half of 2010. If a positive impact is noted with the letter reminder system, the process will be rolled out to ECH as a whole. Dr. Joe Furst and Dr. Kathy MacLaughlin have been involved with that project.

Another area being further explored and promoted by the QI branch of the FM Research Committee is ABFM Maintenance of Certification Part IV credit through participation in Mayo's Quality Review Board process. A group of interested individuals have been identified and will be meeting in the near future to establish the performance measure to be studied and set a timeline.