Back to Search
Start Over
Implementation of disease activity measurement for rheumatoid arthritis patients in an academic rheumatology clinic
- Source :
- BMC Health Services Research, BMC HEALTH SERVICES RESEARCH, vol 16, Bays, A; Wahl, E; Daikh, DI; Yazdany, J; & Schmajuk, G. (2016). Implementation of disease activity measurement for rheumatoid arthritis patients in an academic rheumatology clinic. BMC HEALTH SERVICES RESEARCH, 16. doi: 10.1186/s12913-016-1633-x. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/1s82n139, Schmajuk, Gabriela; Bays, A; Wahl, ER; Daikh, DI; & Yazdany, J. (2015). Implementation of Disease Activity Measurement for Rheumatoid Arthritis Patients in an Academic Rheumatology Clinic. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/0rz059x3
- Publication Year :
- 2016
- Publisher :
- BioMed Central, 2016.
-
Abstract
- Background Treat-to-target is the recommended strategy for the management of rheumatoid arthritis (RA) and involves regular assessment of disease activity using validated measures and subsequent adjustment of medical therapy if patients are not in remission or low disease activity. Recommendations published in 2012 detailed the preferred disease activity measures but there have been few publications on implementation of disease activity measures in a real-world clinic setting. Methods Plan-Do-Study-Act (PDSA) methodology was used over two cycles with a goal of increasing provider measurement of disease activity during all RA patient visits. In PDSA cycle 1, we implemented a paper-based form to help providers assess disease activity in RA patients. PDSA cycle 2 included the creation of separate patient and physician forms for collection of information, identification of patients prior to their clinic visit and incorporation of medical assistants into the workflow. Results The first PDSA cycle improved the number of RA patients with documented disease activity measures from 24 % over a 4-week period, to an average of 44 % over an 8-week period. The second PDSA cycle showed a sustained and dramatic improvement, with 85 % of patients having a disease activity measure recorded over a 27-week period. Conclusions Implementation of disease activity measurement in a typical academic rheumatology clinic can be achieved by standardizing workflow using a simple paper form. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1633-x) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
medicine.medical_specialty
Nursing
Health informatics
Severity of Illness Index
Health administration
Arthritis, Rheumatoid
03 medical and health sciences
Disability Evaluation
0302 clinical medicine
Library and Information Studies
Rheumatology
Internal medicine
Severity of illness
medicine
Humans
030212 general & internal medicine
Disease activity
Quality improvement
Rheumatoid arthritis
Aged
030203 arthritis & rheumatology
business.industry
Health Policy
Nursing research
Public health
Reproducibility of Results
medicine.disease
3. Good health
Health Policy & Services
Public Health and Health Services
Physical therapy
Female
San Francisco
business
PDCA
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....ed3e3f3e88feee71bee82e54c9921f1b