Rheumatoid Arthritis - Develop / Approve Impact Statement

The information below represents aggregated data about your practice that you and/or your designated abstractor submitted throughout your participation in AIM.

Reflect upon and answer the questions as they relate to your experience and the affects that your participation in AIM will have on your practice.

To save data and return at a later time, click the Save button at the bottom of the page.

To approve the impact statement, click the Approve Impact Statement button at the bottom of the page.

To submit your completed module to the American College of Rheumatology for CME credits and the American Board of Internal Medicine for Maintenance of Certification points, click on the Submit Completed Module link on the Main Menu page.

1. Medical Society
American College of Rheumatology

2. Name of Physician (ABIM diplomate):

3. Name of Practice:

4. Target Condition:
Rheumatoid Arthritis

5. Description of Practice Improvement Module:
The American College of Rheumatology's Web-based self-evaluation Rheumatoid Arthritis Practice Improvement Module.

6. Source of your data:
The American College of Rheumatology Rheumatoid Arthritis and Drug Safety Quality Indicators Starter Set.

7. Method used for data collection:
Medical record audit

8. Results/Compliance:
MEASURE:

1. If a patient has a confirmed diagnosis of rheumatoid arthritis, THEN a measure of each of the following should be documented within 3 months of diagnosis and at least annually thereafter: joint exam, functional status assessment, acute phase reactant, measurement of pain, physician global assessment and patient global assessment.

Initial Measures within three months of diagnosis ^QI

1st Abstraction 2nd Abstraction %

n % Goal n % Change

Joint exam 24 96 100 25 100 +4

Functional status assessment 23 92 95 24 96 +4

Acute phase reactant 23 92 95 22 88 -4

Measurement of pain 23 92 95 24 96 +4

Physician global assessment 23 92 95 25 96 +4

Patient global assessment 23 92 95 25 96 +4

Measures Performed within Last 12 Months ^QI

Joint exam 22 88 95 24 96 +8

Functional status assessment 22 88 95 23 92 +4

Acute phase reactant 22 88 95 24 96 +8

Measurement of pain 22 88 95 24 96 +8

Physician global assessment 22 88 95 23 92 +4

Patient global assessment 22 88 95 24 96 +8

9. What was your plan to improve performance on the measure(s) chosen?
I will work with my staff to improve the scheduling of follow-up appointments and establish a method of easily identifying patients who have not received a joint exam, functional status assessment, acute phase reactant, measurement of pain, physician global assessment in accordance with the measures. I will introduce a patient survey for patients to complete prior to visit.

10. What, if any, tool did you use to bring about improvement?
I will begin to use the ACR Patient History Form and Patient/Physician Assessment Forms to ensure charts are consistent and data is easily identifiable.

11. Why did you choose this approach?
The forms will standardize assessments and are easy for office staff and patients to use. In addition, they are readily accessible and can be introduce without great expense to the practice. Will require staff to be proactive in patient care and medical chart documentation.

12. Did you consider other approaches?
I considering introducing an EMR that will assist in scheduling appointments but at this time it is not feasible as I am considering adding a partner to my practice.

13. Do you believe the results for each measure are reliable? (select one)
Yes
No
Please explain:
Yes, my office manager and PA are efficient and effective at their positions, and the chart data is reliable.

14. Do you think the measures evaluate important aspects of care within RA and your practice?
Yes
No
Please explain:
Yes, my office manager and PA are efficient and effective at their positions, and the chart data is reliable.

15. Did you encounter any problems in implementing the improvement plan?
Yes
No
If yes, please explain changes
N/A

16. Did any change in behavior occur in those involved in implementing your improvement plan?
Yes
No
If yes, please explain changes
Yes, our office procedures bcame more efficient and we became more effective at caprturing the information needed through offering patient surveys at each visit. The survey mechanism served as a reminder to ensure proper documentation and improved consistency with follow up appointments and office procedures.

17. As a result of completing this activity, what did you learn about your practice process(es) or system of care?
The office procedures and documentation needed improvement; office staff appreciated the additional training and guidance; the ACR forms are extremely useful, as was the patient survey.

18. Do you believe your patients will benefit from the changes?
Yes
No
Please explain:
Increased office efficientcy; better trained staff; everyone invloved with patient care; approrpiate use of forms and better documentation; all of these assist me in providing better quality care to my patients.

19. What are the next steps that you will take to improve quality in your practice?
Continue to monitor and ensure proper documentation, office staff aware of and following procedures, and that patients take interest in treatment; seriously consider use of EMR to take practice to the next level; redo the PIM in another 6 – 12 months to evaluate changes further.