scholarly journals Improving patient portal enrolment in an academic resident continuity clinic: quality improvement made simple

2019 ◽  
Vol 8 (2) ◽  
pp. e000430 ◽  
Author(s):  
Courtney Rhudy ◽  
Jane Broxterman ◽  
Sara Stewart ◽  
Victoria Weaver ◽  
Cheryl Gibson ◽  
...  

Electronic health record patient portal usage has been associated with improvement in chronic disease parameters, patient functional status and patient satisfaction. Our institution’s patient portal is a secure, online health management tool that connects patients to portions of their electronic health record.Our quality improvement project aimed to increase patient portal enrolment significantly in our Internal Medicine resident patient panels.This study was conducted in a large, multisite health system in Kansas City, Kansas that serves a diverse patient population. Our clinic includes 65 resident patient panels. We followed a subset of 16 resident patient panels in this quality improvement project. A baseline audit showed that 35% of the 1628 patients in these panels were enrolled in the patient portal system. A standardised, nurse-initiated portal sign-up process following patient rooming was implemented. Initial results indicated a 9.6% increase in patient portal sign-up at the end of the first 4-week cycle. We then implemented educational sessions for our clinic nurses as well as attending physicians, and achieved a 15.1% increase from baseline to the end of the second 4-week cycle, resulting in 86 patient portal activations (p<0.01).Resident physicians worked with clinic nurse partners in two formats for this project. Nurses assigned to patient rooming for residents during the clinic sessions being studied (rooming nurses) initiated the portal sign-up process. Nurses assigned to partner with the resident for longitudinal patient care management, anchor nurses, worked with residents on items such as phone messages or portal messages. Semi-structured interviews of the four anchor nurses aligned with the 16 residents were conducted at the end of the study and revealed that nursing staff perceived increased patient portal activity to be associated with a decrease in nursing workload and an increase in patient engagement.

2016 ◽  
Vol 07 (03) ◽  
pp. 653-659 ◽  
Author(s):  
Donglin Yan ◽  
Rosemarie Conigliaro ◽  
Laura Fanucchi

SummaryCommunication errors are identified as a root cause contributing to a majority of sentinel events. The clinical note is a cornerstone of physician communication, yet there are few published interventions on teaching note writing in the electronic health record (EHR). This is a prospective, two-site, quality improvement project to assess and improve the quality of clinical documentation in the EHR using a validated assessment tool.Internal Medicine (IM) residents at the University of Kentucky College of Medicine (UK) and Montefiore Medical Center/Albert Einstein College of Medicine (MMC) received one of two interventions during an inpatient ward month: either a lecture, or a lecture and individual feedback on progress notes. A third group of residents in each program served as control. Notes were evaluated with the Physician Documentation Quality Instrument 9 (PDQI-9).Due to a significant difference in baseline PDQI-9 scores at MMC, the sites were not combined. Of 75 residents at the UK site, 22 were eligible, 20 (91%) enrolled, 76 notes in total were scored. Of 156 residents at MMC, 22 were eligible, 18 (82%) enrolled, 40 notes in total were scored. Note quality did not improve as measured by the PDQI-9.This educational quality improvement project did not improve the quality of clinical documentation as measured by the PDQI-9. This project underscores the difficulty in improving note quality. Further efforts should explore more effective educational tools to improve the quality of clinical documentation in the EHR. Citation: Fanucchi L, Yan D, Conigliaro RL. Duly noted: Lessons from a two-site intervention to assess and improve the quality of clinical documentation in the electronic health record.


2016 ◽  
Vol 12 (2) ◽  
pp. e231-e240 ◽  
Author(s):  
Laurie L. Carr ◽  
Pearlanne Zelarney ◽  
Sarah Meadows ◽  
Jeffrey A. Kern ◽  
M. Bronwyn Long ◽  
...  

Introduction: Our objective was to improve communication concerning lung cancer patients by developing and distributing a Cancer Care Summary that would provide clinically useful information about the patient’s diagnosis and care to providers in diverse settings. Methods: We designed structured, electronic forms for the electronic health record (EHR), detailing tumor staging, classification, and treatment. To ensure completeness and accuracy of the information, we implemented a data quality cycle, composed of reports that are reviewed by oncology clinicians. The data from the EHR forms are extracted into a structured query language database system on a daily basis, from which the Summaries are derived. We conducted focus groups regarding the utility, format, and content of the Summary. Cancer Care Summaries are automatically generated 4 months after a patient’s date of diagnosis, then every 6 months for those receiving treatment, and on an as-needed basis for urgent care or hospital admission. Results: The product of our improvement project is the Cancer Care Summary. To date, 102 individual patient Summaries have been generated. These documents are automatically entered into the National Jewish Health (NJH) EHR, attached to correspondence to primary care providers, available to patients as electronic documents on the NJH patient portal, and faxed to emergency departments and admitting physicians on patient evaluation. Conclusion: We developed a sustainable tool to improve cancer care communication. The Cancer Care Summary integrates information from the EHR in a timely manner and distributes the information through multiple avenues.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
María E. Martín-Méndez ◽  
Vanesa García-Díaz ◽  
Paula Zurrón-Madera ◽  
Ana Fernández-Feito ◽  
Franz Jimeno-Demuth ◽  
...  

2018 ◽  
Vol 31 (3) ◽  
pp. 398-409 ◽  
Author(s):  
Jennifer R. Hemler ◽  
Jennifer D. Hall ◽  
Raja A. Cholan ◽  
Benjamin F. Crabtree ◽  
Laura J. Damschroder ◽  
...  

2018 ◽  
Vol 20 (6) ◽  
pp. e208 ◽  
Author(s):  
Seuli Bose-Brill ◽  
Michelle Feeney ◽  
Laura Prater ◽  
Laura Miles ◽  
Angela Corbett ◽  
...  

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