Background: U.S. healthcare costs have increased exponentially to almost $4 trillion. Despite increased costs, patient outcomes remain suboptimal. It is imperative that primary care providers are intentional with testing and medical technology to improve effective care.
Local problem: Preintervention chart audits showed average overspending of $79.41 per provider per day. Despite overspending, outcomes are not optimal. Only 48% of persons with hypertension and 38% of persons with diabetes at Orange Blossom Family Health (OBFH) are controlled. The aim of this 8-week quality improvement (QI) project was to decrease lab spending by 20% for adult primary care patients at OBFH.
Methods: A rapid cycle QI initiative of four Plan-Do-Study-Act cycles, 2 weeks each, was completed to implement four interventions concurrently. The data was assessed every 2 weeks with iterative tests of change as indicated.
Interventions: The primary care quality metrics chart audit and preclinical care coordination tools were developed, and the My Life, My Healthcare tool and medical assistant (MA)-provider huddles were initiated with the focus on effective patient care.
Results: A savings of $3406.43 on overordering of labs by one provider in 8 weeks was identified. The average provider compliance to national guidelines was found to be 54.1%. There was a 19.3% increase in referrals. MA-provider huddles were balanced for this initiative.
Conclusions: The initiative addressed effective care through awareness of resource allocation, patient engagement, and team communication. Continued application of these core interventions will ensure consistent and quality healthcare.
Keywords: My Healthcare; My Life; huddle; minimally disruptive medicine; overuse; preclinical care coordination; underuse.
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