PDSA Cycles and QI Presentations
Links to Quality Improvement projects completed by residents and staff.
Quality Improvement Projects
We have multiple quality improvement projects being conducted in our clinic. The Enhanced Care Team care assistants as well as residents in the ambulatory care continuity elective are required to complete a project. We use Plan-Do-Study-Act (PDSA) worksheets to help organize, design and summarize each project. Each cycle of a PDSA represents work focused around a particular test or intervention and any one project can be comprised of multiple cycles of change each led by a different person. Each project or cycle is usually led by one person with group input during the process.
Clinical Quality Improvement projects |
Process Quality Improvement projects |
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Depression and Suicidality Assessment |
Provider Communication of Test Results |
Clinical Quality Improvement projects
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Date |
Topic |
Key Contributors |
Links |
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April 08 |
Coumadin Visual Dosing chart |
Escher Howard-Williams, MD (PGY3) |
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Nov 07 |
Screening |
Leslie Proctor, MD (PGY2) |
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Dec 09 |
Screening Process |
Amanda Allen, MD (PGY1), Kiran Venkatesh, MD (PGY1) |
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Jan 10 |
Abnormal Pap Smear Tracking |
Jacob Kulander, MD (PGY1), Tara O”Brien, MD (PGY1) |
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Jan 08 |
Improving Appointment Cycle Times in the Pain Clinic |
Kelly Hayes, Pain CA |
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Dec 10 |
Influence of Decision Aid among patients with Chronic Pain |
Joseph Bumgarner, MD (PGY1) |
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Dec 10 |
Pain Management Pre-Clinic Conference |
Shaili Shah, MD (PGY1) |
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| April 11 | Treating Pain in Same Day Clinic | Jacqueline Terry, MD (PGY1) | Presentation | |
| June 11 | Pain in the Same Day Clinic | Elaine Sunderlin, MD (PGY-3) | PDSA, Presentation | |
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Aug 09 |
Screening Process |
Thomas Alexander, MD (PGY1), John Rommel, MD (PGY1) |
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Oct 09 |
Screening Process, cycle 2 |
Shatima Seward, MD (PGY1) |
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Feb 11 |
Practice Standards for Positive FOBTs |
Adrian Austin, MD (PGY1) |
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Feb 09 |
ID and Treatment cycle 1 |
Seulli Brill (PGY4) |
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July 09 |
ID and Treatment cycle 2 |
Alexis Ponder , MD (PGY1), Stacy Cowherd, MD (PGY1) |
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Aug 09 |
Review of Current Process |
Kate Gerrald, Pharm D, (PGY2) |
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Oct 09 |
Increasing diagnosis and treatment |
Ben Vincent, MD (PGY1) |
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Nov 09 |
Provider and Nurse Training on depression assessment and treatment |
Niya Mukherjee, MD (PGY1), Derek Seib, MD (PGY1) |
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Sept/Nov 09 |
Phone follow-up using script |
Cole Andrew, Pain CA |
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Jan 10 |
Patient Self-Administration of PHQ9 |
Diane Dolan-Soto, LCSW |
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March 10 |
Screening with the PHQ9 and Provider usage of Visit Planner prompts |
Sherwin Yen, MD (PGY1) |
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April 10 |
Suicidality Assessment - Documentation and Algorithm |
Stephen Telloni, MD (PGY1) |
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May 10 |
Depression Treatment Algorithm |
Kamal Kolappa, MD (PGY1) |
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May/June 10 |
Depression Treatment Algorithm and Medication Therapy |
Grant Williams, MD (PGY1) |
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May/June 10 |
Depression and Suicidality Assessment Training Module |
Matt Volk, MD (PGY3), Pat Barrett, MD (PGY1), Grant Williams, MD (PGY1) |
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Aug/Sept 10 |
Depression Evaluation and Management |
Kathryn Johnson, MD (PGY1) |
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Sept/Oct 10 |
Evaluation of Depression and Suicidality Assessment Education |
Kathryn Richards, MD (PGY1) |
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| Jan 11 | Ensuring Treatment of Severely Depressed patients | Aditi Puri, MD (PGY1) | PDSA, Presentation | |
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Feb 11 |
2-week follow up phone calls |
Sarina Pasricha, MD (PGY1) |
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| Aug/Sept 11 | Analysis on Adherence to the Depression Algorithm | Sherwin Yen (PGY3) | PDSA, Presentation | |
| Aug/Sept 11 | Use of Depression Decision Aids | Genevieve Embree (PGY1) | PDSA, Presentation | |
| Dec 11 |
Provider Response to the PHQ-9 and Depression Decision Aid Prescription |
Liliana Bustamante and Stephanie Davis (PGY1) | PDSA, Presentation | |
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July/Aug 08 |
Contraceptive Status |
Elizabeth Dehmer, MD (PGY3) |
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Feb/March 09 |
Contraception counseling |
Nicole Cullen, MD (PGY1) |
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August 08 |
Foot Care cycles 1 & 2 |
James Hawk, MD (PGY3) |
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Aug/Sept 08 |
Foot Care cycle 3 |
Elaine Sunderlin, MD (PGY1), James Hawk, MD (PGY3) |
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Sept/Oct 08 |
Foot Care – cycle 4: Assess adherence to new Foot Care Algorithm |
Matt White, MD (PGY1) |
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Sept 08, Nov 08 |
Medication Utilization – Aspirin cycles 1 & 2 |
Meg Rutledge, Diabetes CA |
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Feb 08 |
Medication Utilization – ACE-iARB and Nephropathy |
Jordan Kautz (MSY4) |
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Oct 07, Feb 08, Apr 08 |
Medication Utilization – Insulin not used with A1c > cycles 1, 2 & 3 |
Angela Thompson, Diabetes CA |
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Nov 07, Mar 08 |
Medication Utilization - Statin cycles 1 & 2 |
Carolyn Menzie, Diabetes CA |
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Aug 08, Dec 08 |
Medication Utilization – Statin, low dose increase cycles 1 & 2 |
Lauren McKnight, PharmD (PGY1) |
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Oct 08 |
BP measurement |
Amy Auerbach, MD (PGY2) |
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Nov 07 |
Same Day Clinic cycle 1 |
Jennifer Pagliei, MD (PGY3) |
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Dec 07 |
Same Day Clinic – sticker cycle 2 |
Ryan Sanford, MD (PGY1) |
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Jan/Feb 08 |
Same Day Clinic - sticker cycle 3 |
Krista Fajman, MD, (PGY1) |
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Mar 08 |
Same Day Clinic cycle 4 |
Kunwar Sohal (PGY1) |
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Oct 07 |
Chronic Kidney Disease |
Jennifer Rogers, MD (PGY3) |
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Aug 08 |
Obesity screening and action plan |
David Rometo, MD (PGY3) |
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Oct 08 |
Screening and obesity management |
David Rometo, MD (PGY3) |
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Aug 09 |
Weight Loss Decision Aid |
Evan Morgan, MD (PGY1), Caitlyn Molino, MD (PGY1) |
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Dec 10 |
Weight Loss Surgery Pre-Clinic Conference |
Jennifer Kinley, DM (PGY1) |
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Process Quality Improvement projects
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Date |
Topic |
Key Contributors |
Links |
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May/June 08 |
Electronic Referrals |
Ademola Aderoju, MD (PGY3) |
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E-Prescription |
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| Aug 11 | E-Prescription: Usage rates and interventions | Michael Bode (PGY1) | PDSA, Presentation | |
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July-Aug 11 |
E-Prescription: Usage rates and intervention |
Julia Hughes (PGY1) and Nicole Harlan (PGY1) |
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| July 11 | E-Prescription Rates, Cycle 2 | Chris Hauck (PGY1) | PDSA, Presentation | |
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January 11 |
E-Prescription, Cycle 1 |
DJ Patel |
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Jan/Feb 11 |
Implementation of the Medicare Annual Wellness Visit, cycle 1 |
Sara Faber, MD (PGY4) |
Presentation |
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March 11 |
Implementation of the Medicare Annual Wellness Visit, cycle 2 |
Christina Prather, MD (PGY1) |
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Sept/Oct 10 |
Patient Agenda Setting pilot |
Adam Creech, MD (PGY2) |
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Nov 10 |
Patient Agenda Setting, cycle 2 |
Tanvir Haque, MD (PGY1) |
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Oct/Nov 08 |
Barriers to coming to appointments |
Britni Hebert,MD (PGY1) |
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Feb 10 |
Stratifying No Show patients |
Ed Barnes, MD (PGY1), Adam Creech, MD (PGY1) |
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Apr/May 10 |
Advanced Case Management |
Maggie Davis-Hovda, MD (PGY3) |
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Jan/Feb 10 |
Awareness by residents of Patient Satisfaction measures |
Jessie Stewart, MD (PGY3) |
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June/July 10 |
Patient Satisfaction & 360 Resident Evaluation Instrument Development, Cycle 1 |
Lindsay Goetz, MD (PGY1), Greg Knight, MD (PGY1) |
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July/Aug 10 |
Patient Satisfaction & 360 Resident Evaluation Pilot Implementation, Cycle 2 |
Diana Feldstein, MD (PGY1), Daniel Matthews, MD (PGY1) |
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Aug/Sept 10 |
Patient Satisfaction & 360 Resident Evaluation Clinic Implementation, Cycle 3 |
Lee Sigmon, MD (PGY1) |
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Mar 08 |
Point of Care Testing cycle 1 |
Abigail Miller, pharm student |
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June 08, July 08 |
Re-evaluation of implementation cycles 2 & 3 |
Andrew Maclennan, MD (PGY1) |
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Jan/Feb 08 |
Patient Correspondence cycle 1 |
Micah Mooberry, MD (PGY4) |
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May/June 09 |
Patient Correspondence cycle 2 |
Chris Caulfield, MD (PGY1) |
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July/Aug 09 |
Patient Correspondence cycle 3 |
Kristen Amann, MD (PGY3) |
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Sept/Oct 09 |
Residents and Patient Correspondence, cycle 4 |
Kunwar Sohol, MD (PGY3) |
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Sept/Oct 10 |
Patient Correspondence: Meeting practice standards |
David McNeely, MD (PGY1) |
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Mar/Apr 09 |
Resident Physician messaging cycle 1 |
Liz Thomas, MD (PGY3) |
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May/June 09 |
Resident Physician messaging cycle 2 |
Sally Ravenos, MD (PGY4) |
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Oct/Nov 10 |
Prior-authorizations turn-around time |
Katy Tsai, MD (PGY1) |
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July/Aug 10 |
Resident Panel Review |
Alexis Ponder, MD (PGY2) |
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| Nov 11 | Clinic Satisfaction Survey | Kamal Kolappa (PGY-3) | Presentation | |
| Nov 11 | Telephone Medicine | Brad Barnes (PGY-3) | Presentation | |
| Nov 11 | Telephone Messages |
Adam Butaine (PGY-1), Suzanne Weaver (PGY-1) |
PDSA, Presentation | |
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Dec 07, Mar 08 |
Tracking Nurse Diabetes Tasks cycles 1 & 2 |
Regina Boone, Diabetes CA |
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Mar 10 |
Visit Planner 5.0 Rollout Training and Usage |
Scott Haake, MD (PGY1) |
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Apr/May 10 |
Visit Planner 5.0, cycle 1: Survey and Compliance |
Maggie Davis-Hovda, MD (PGY3) |
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May 10 |
Visit Planner 5.0, cycle 2: Usage and CIS documentation |
Pahresah Roomiany, MD (PGY1) |
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June 10 |
Visit Planner 5.0, cycle 3: Improving compliance and usage |
Fernanda Payan Schober, MD (PGY1) |
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March 11 |
Visit Planner: Revised Provider Responsibilities for Depression Treatment |
Domenick Roma, MD (PGY3) |
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