Quality Improvement of Diabetic Care at a Resident Clinic

Punzalan, Carmi S.; Rutherford, Sarah; Lerner, Andrew D.; Kouvatsos, Tasha; Thakkar, Sneha; Klein, Melissa; Manoff, David; Kelly, Cecelia; Halegoua, Dina; Kane, Gregory C.

doi:10.29046/tmf.013.1.003

Cited by 2 publications

(4 citation statements)

References 19 publications

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“…Our study contributes to the literature supporting the effectiveness of quality improvement projects in resident clinics to improve diabetic nephropathy. 11 – 13 Furthermore, it adds to the small amount of literature available showing the success of resident-led quality improvement projects to address this national gap in screening for diabetic nephropathy such as Curran’s resident-led project using the HEDIS measure for nephropathy. 11 The benefits of a resident-led approach include accomplishing the Accreditation Council for Graduate Medical Education requirements surrounding experiential learning in quality improvement, accomplishing the Clinical Learning Environment Review requirements, and resident “buy in” or engagement.…”

Section: Discussionmentioning

confidence: 99%

“… 3 , 9 , 10 A 2020 article from Curran et al described senior residents leading a successful quality improvement project to improve the resident clinic compliance with the Medicare Healthcare Effectiveness Data and Information Set (HEDIS) measure for “medical attention to nephropathy.” 11 Other studies have been done in resident clinics but the effect and feasibility of a resident-led quality improvement initiative for diabetic nephropathy is not well-known. 11 – 13 …”

Section: Introductionmentioning

confidence: 99%

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Getting Ahead: A Resident Led Quality Improvement Project to Increase Diabetic Nephropathy Screening in an Underserved Hispanic-Predominant Population

Luu¹,

Rivera²,

Marín-Aragón³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

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Introduction Diabetes is the leading cause of end-stage renal disease (ESRD) in the United States (US), with 37 million having chronic kidney disease. Despite national guidelines recommendations for diabetic nephropathy screening with urine albumin-to-creatinine ratio (UACR), less than 50% receive full screening. Our Internal Medicine residents led a quality improvement project to increase diabetic nephropathy screening rate with UACR in our resident clinic by 50% in one academic year. Methods We conducted the resident-led quality improvement project from July 2021 to April 2022. We reviewed the electronic medical records (EMR) from our clinic pre-intervention July 2020 to June 2021 and compared this to post intervention July 2021 to March 2022 determining the nephropathy screening rates in patients with diabetes. Our interventions included resident education, pre and post surveys to test foundational knowledge, adding UACR in the affordable laboratory order form and establishing normal reference range of UACR in the EMR. Results We collected 217 patients with diabetes, 27% were uninsured, 38% had Medicare/Medicaid and 90% identified as Hispanic. Comparing pre to post intervention, there was a significant change of 45 (20.7%) vs 71 (32.7%) patients screened for diabetic nephropathy with a UACR. The correct average score of knowledge-based questions was 82% on the pre survey, which increased to 88% in the post survey. Conclusion Our study showed promising results on improving diabetic nephropathy screening. The comprehensive approach including resident education about diabetic nephropathy screening with UACR and more so facilitating the order set in the EMR were key to achieve this goal.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Getting Ahead: A Resident Led Quality Improvement Project to Increase Diabetic Nephropathy Screening in an Underserved Hispanic-Predominant Population

Luu¹,

Rivera²,

Marín-Aragón³

et al. 2022

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

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“…15 Many studies find that, while residents have a positive attitude about practice transformation, they feel that they were lacking the knowledge and skills of practicing, teaching, and leading these efforts. 9,11,16,17 Often residents take a passive role in these initiatives during their training and thus are not optimally prepared. 18 Many of the studies conducted regarding this topic confine the approach to a single institution, rather than a larger approach, when addressing population health issues.…”

Section: Wvmj Oamentioning

confidence: 99%

“…18 Many of the studies conducted regarding this topic confine the approach to a single institution, rather than a larger approach, when addressing population health issues. 9,16,17,19 There are advantages to creating a collaborative learning group for residents. Through these learning groups, residents are often shown how to examine their own data and to summarize what the data shows.…”

Section: Wvmj Oamentioning

confidence: 99%

Residents’ Views on Research and Quality Improvement Training Can Guide Practice-Based Research Network Collaboration

Haggerty

Lewis

Plaugher

et al. 2018

WVMJ

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Background and Objectives: This study was conducted by the West Virginia Practice-Based Research Network Learning Collaborative to assess research activity, confidence, and attitudes toward residency programs' research and quality improvement requirements and inform the integration of the statewide practicebased research network (PBRN) as mentors to support practice transformation implementation initiatives across various resident training sites in West Virginia. Methods: This pilot study assessed residents' attitudes regarding (1) research activity, (2) confidence and (3) requirements of their program in research and quality improvement training by using an anonymous survey, administered during regular residency meetings. Results: Of the 68 residents, representing four DO and MD Family Medicine residency programs in West Virginia, 40 (58.8%) responded to the survey. About 64 percent of residents had worked on a quality improvement project, and more than half of residents (52.5%) submitted a research project for a competitive presentation within the most recent year. Sixty-five percent felt satisfied with the residency program's research and quality improvement curriculum. However, only 55 percent felt confident to perform a project and 52 percent submitted a project to a competitive forum. Conclusion: Only half of the residents demonstrate activity and confidence in research and quality improvement. This shows an opportunity to assess current curriculums and provide new strategies to enhance their ability to conduct practice transformation initiatives.

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Quality Improvement of Diabetic Care at a Resident Clinic

Cited by 2 publications

References 19 publications

Getting Ahead: A Resident Led Quality Improvement Project to Increase Diabetic Nephropathy Screening in an Underserved Hispanic-Predominant Population

Getting Ahead: A Resident Led Quality Improvement Project to Increase Diabetic Nephropathy Screening in an Underserved Hispanic-Predominant Population

Residents’ Views on Research and Quality Improvement Training Can Guide Practice-Based Research Network Collaboration

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