A Quality Improvement Project to Increase Patient Portal Enrollment and Utilization in Women Living With HIV at Risk for Disengagement in Care

2020 ◽  
Vol 31 (1) ◽  
pp. 60-65
Author(s):  
Erica Plimpton
2019 ◽  
Vol 38 (2) ◽  
pp. 115-129
Author(s):  
Lauren C. Mays ◽  
Jennifer W. Drummonds ◽  
Summer Powers ◽  
David R. Buys ◽  
Penni I. Watts

2013 ◽  
Vol 37 ◽  
pp. S56
Author(s):  
Geetha Mukerji ◽  
Dina Reiss ◽  
Ferhan Siddiqi ◽  
Steven Sovran ◽  
Zoe Lysy ◽  
...  

2020 ◽  
Vol 9 (3) ◽  
pp. e000893
Author(s):  
Abha Mehndiratta ◽  
Satish Chandra Mishra ◽  
Prashant Bhandarkar ◽  
Kunal Chhatbar ◽  
Francoise Cluzeau ◽  
...  

The majority of foot amputations are preventable in people with diabetes. Guidelines recommend that people with diabetes should receive a foot examination for risk assessment, at least annually. In an audit at a primary health centre (PHC) in Mumbai, India, no patient with diabetes was offered preventive foot assessment in preceding 12 months. Problem analysis identified a lack of clinic policy, training and equipment for foot assessment. There was no standardised referral pathway for patients identified with foot at risk of diabetes complications. Furthermore, limited data review, high patient volumes and little time available with healthcare providers were important constraints. A quality improvement project was carried out at the PHC from January to September 2017. The project aimed at increasing compliance to standardised foot assessment in patients with diabetes presenting to the PHC from a baseline of 0% to 100% over 6 months. This would help identify patients having a foot at risk of complications due to diabetes. The Quality Standard on foot assessment was adopted from the Ministry of Health and Family Welfare Diabetic Foot Guideline. The electronic medical record (EMR) was standardised, health providers were trained, PHC processes and referral pathways were redesigned. Plan-Do-Study-Act was used to address barriers with weekly data review. 88.2% (848) of patients with diabetes visiting the PHC during the study period received a foot examination. Out of these, 11% (95) were identified to have a foot at risk and referred to a specialist foot centre. 57% of referred patients followed with specialised foot protection services. Training of healthcare providers, standardisation of processes and regular data feedback can improve diabetic foot care. Integrating quality indicators in the EMR helps monitor compliance. The inability to use doctor’s time efficiently was the biggest challenge and sustaining the change will require organisational changes with suitable task shifting.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Sambhwani ◽  
A Kandiah ◽  
F Rayan ◽  
A Wazir ◽  
N Sheikh

Abstract Introduction A service evaluation audit highlighted significant variation in our practice as regards catheterisation in NOF patients. A pilot protocol was developed with real time data monitoring to see if we could improve our patients’ pathway. Method The protocol focussed on early catheterisation, monitoring the condition of patients’ skin, documentation around catheter care and removal instructions and surveillance for urinary tract infection rates (UTI) Results 150 patients were included in the pilot. There was a reduction by more than 50% of patients assessed as having at risk or broken skin. 94.5% of patients were catheterised out of theatres (previously only 4%) saving an average of 14 minutes of theatre time per case. Delays in catheter removal after documented request reduced by 2 days and our UTI rates were relatively unchanged (3.3% compared to 2.7%). Documentation significantly improved. We also noted that overall length of stay was reduced by 2 days. Conclusions Standardising our care pathway has improved our patient care and documentation. It has benefitted theatre efficiency and also nursing of fragile skin in 'at risk' patients. Prompting early removal and compliance may have also had a positive impact on overall length of stay. This has been a successful quality improvement project in our department.


2013 ◽  
Vol 39 (5) ◽  
pp. 510
Author(s):  
Rosemary Sedgwick ◽  
Sophie Bates ◽  
Dibendu Betal ◽  
Ayesha Kahn ◽  
Giles Davies ◽  
...  

2018 ◽  
Author(s):  
Cheryl Stone ◽  
Becky Faett ◽  
Kathy Magdic

BACKGROUND Efforts in the United States to improve patient engagement and communication with health care providers have led to the creation of the meaningful use program. [1] The Centers for Medicare and Medicaid Services have created a three-stage process to encourage the adoption and use of electronic health records (EHR). Benefits of EHR use include the ability to provide accurate, up-to-date, legible, and complete information about patients at the point of care. One important component of EHR is the patient portal. Patient portals provide 24-hour access to portions of a patient medical record as well as a secure pathway to send messages to providers, ask for refills of medications, and schedule appointments. OBJECTIVE To assess if patients who have not used the patient portal will engage in using the portal after an in-office orientation on how to access and the benefits of using the patient portal. METHODS A quality improvement project was performed using a convenience sample of 60 participants who were scheduled for an appointment in an outpatient cardiology office and had not accessed the patient portal in the past 12 months. The participants were given a survey regarding their computer and internet access as well as their level of comfort using a computer. Each participant was assisted in creating a username and password as well as a security question and answer. The participant then accessed the portal and navigated through the portal with the guidance of the nurse practitioner. They also sent a message via the portal to the provider they were assigned to that day. Each participant was given a pamphlet and a printed power point to reinforce what they had learned. After two months, the nurse practitioner accessed the portal to determine if the enrolled participants had accessed the portal. The reasons for access and frequency were recorded. If there was no access, the participant was called by the nurse practitioner to determine the reason they had not accessed the portal. RESULTS Of the 60 participants, 54% were women, 46% men, 93% were Caucasian. Fifty-six point seven accessed the portal from home. Reasons for access included: 85% reviewed labs, 53% reviewed messages sent to them from the office and 23% sent messages to the office. Twenty-four participants did not access the portal. Of those participants, 33% stated that they had no clear reason to access the portal, 25% stated that they forgot their login information and 17% stated they no interest in the portal. CONCLUSIONS Patient portals are a useful tool for communication between patients and their providers. Providing an in-office orientation to the portal increased patient access to the portal.


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