A Quality Improvement Committee Based at a Primary Care Clinic

A quality improvement committee based at a primary care clinic wishes to improve screening and follow-up of patients with obesity.  Currently, 30% of patient encounters include documentation of BMI, and 10% of patients with BMI ≥30 kg/m² are scheduled for weight management follow-up appointments.  The committee sets a goal to increase BMI documentation to 40% and BMI follow-up to 30% in 3 months.  It decides to test the effectiveness of a clinical decision support tool in achieving this goal.  The tool is designed for clinical providers and integrated into the electronic medical record; it includes a BMI calculator and a prompt to arrange follow-up when BMI is ≥30 kg/m².  An email introducing the tool and its purpose is circulated to all clinical providers. Three months after implementation of the tool, the committee analyzes patient charts to determine changes in obesity screening and follow-up.  They find that obesity documentation now occurs in 32% of patients and that follow-up is arranged for 12% of patients with BMI ≥30 kg/m².  The clinic's providers report that, while the tool functions properly, they often overlook it because patient vital sign measurement, including weight, and arrangement of follow-up appointments are typically part of medical assistant workflow.  Which of the following is the most appropriate subsequent action?

A) Discard the tool as it is clearly ineffective in achieving intended goals
B) Redesign the tool with increased frequency of alerts tailored toward clinical providers
C) Repeat testing of the tool and collection of data for another 3 months
D) Revise BMI screening and follow-up goals to be more specific and realistic
E) Train medical assistants in using the tool for BMI documentation and follow-up

Correct Answer:

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