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By: MAG Mutual’s Risk and Patient Safety Department
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A four-doctor pediatrics practice wanted to improve flu vaccination rates, especially for its asthma patients. Initially, they considered adding a chart stamp to prompt better follow up by the lax parents.
However, after performing a random chart audit of asthma patients, they learned that the records often lacked the key elements necessary for effective disease management: specifically an action plan, a school plan, confirmed flu vaccination and documented, solid patient education. Peak flow measures were also inconsistently taken and charted.
The practice’s first reaction to these discoveries was hesitation. The physicians feared that productivity would suffer because they would have to bear the full burden of longer patient encounters and more detailed charting. The nursing staff resisted change because they feared being frustrated and overwhelmed by a new, untested process.
Despite these early concerns, the patient management process was refined by updating the encounter forms and having the MAs take peak flow measures. The patient education process was also improved by updating education materials and reinforcing the importance of routine follow-up.
Ultimately, the number of patient ER visits dropped significantly due to the more effective patient management that sprang from the initiative. More than that, however, the doctors and staff took ownership of the practice’s processes.
The practice finally took the program to the next level by receiving a grant to teach its chronic disease management method to two other groups of specialists in the area, family medicine and internal medicine physicians.
To read an unabridged version of this article and for more tips and tools to help you establish a QI process in your practice, visit our newest website link at: www.magmutual.com/risk/RMQuality_PatSaf.html. Included on our website is ABIM’s video, “Putting Quality into Practice: Physicians in Their Own Voices.”
