AACE Advancing Immunization Quality Improvement Communication Platform-AACE HSP QI Project Case Study

AACE HSP QI Project Case Study

Pdf Summary

This case study focuses on a quality improvement project aimed at improving documentation of the CHA2DS2-VASc score in a Cardiovascular Clinic. The benchmark data showed that only 31% of physicians correctly documented the score, while 11% documented it incorrectly and 58% did not document it at all. The goal of the project was to increase the rate of accurate documentation from 30% to 80% within 3 months.<br /><br />The project team consisted of office administrative staff, providers, office clinical staff, and physician administrators. They brainstormed options and reviewed the clinic's processes to identify opportunities for improvement. Paper-based tools, such as bright yellow flags and worksheets, were implemented to remind physicians to document the score during patient visits.<br /><br />Three Plan-Do-Study-Act (PDSA) cycles were conducted. In the first cycle, the team found that physicians were unsure about the project but still showed improvement in documentation. In the second cycle, communication about the project was sent to physicians, resulting in even better documentation rates. The third cycle showed a significant improvement, with 90% of CHA2DS2-VASc scores being correctly documented.<br /><br />Factors contributing to the success of the project included multiple methods for identifying patients with atrial fibrillation and the use of a scoring form in the examination room. On the other hand, factors detrimental to success included the lack of a discrete field for the score in the electronic health record and physician fatigue.<br /><br />Overall, the project achieved its documentation goal but not its goal of implementing a sustainable process due to the lack of automation. The team plans to work on implementing automated alerts for appropriate anticoagulation in future projects. The project was well-received by clinic staff and identified potential QI champions for future initiatives.

Keywords

quality improvement project

documentation

CHA2DS2-VASc score

Cardiovascular Clinic

physicians

project team

improvement in documentation

communication

electronic health record

automated alerts