The uptake of family screening in hypertrophic cardiomyopathy and an online video intervention to facilitate family communication.

Background: Individuals with hypertrophic cardiomyopathy (HCM), even when asymptomatic, are at-risk for sudden cardiac death and stroke from arrhythmias, making it imperative to identify individuals affected by this familial disorder. Consensus guidelines recommend that first-degree relatives (FDRs) of a person with HCM undergo serial cardiovascular evaluations.

Methods: We determined the uptake of family screening in patients with HCM and developed an online video intervention to facilitate family communication and screening.

Improving Influenza and Pneumococcal Vaccination Rates in Ambulatory Specialty Practices.

Background.  Influenza and pneumococcal vaccinations are recommended for elderly and high-risk patients; however, rates of adherence are low. We sought to implement influenza and pneumococcal vaccine initiatives in 4 different ambulatory specialty practices, using 3 unique approaches.

Meaningful measurement: developing a measurement system to improve blood pressure control in patients with chronic kidney disease.

Objectives: To develop an electronic registry of patients with chronic kidney disease (CKD) treated in a nephrology practice in order to provide clinically meaningful measurement and population management to improve rates of blood pressure (BP) control.

Methods: We combined data from multiple electronic sources: the billing system, structured fields in the electronic health record (EHR), and free text physician notes using natural language processing (NLP). We also used point-of-care worksheets to capture clinical rationale.

Increasing pneumococcal vaccination for immunosuppressed patients: a cluster quality improvement trial.

Objective: Pneumococcal vaccination is important for patients taking immunosuppressive medications, but prior studies suggest that most patients do not undergo vaccination. The aim of this study was to evaluate the effects of a point-of-care paper reminder form as a quality improvement (QI) strategy to increase the numbers of immunosuppressed patients being kept up-to-date with pneumococcal vaccination in a rheumatology practice.

Methods: Selected rheumatologists at 5 ambulatory practice sites received a point-of-care paper reminder form to be applied to patients who were not up-to-date with pneumococcal vaccination.

Building a departmental quality program: a patient-based and provider-led approach.

Quality improvement in health care today requires a comprehensive approach. Improvement efforts led by patients, payers, regulators, or health care providers face many barriers. Obstacles include selecting measures with clinical value, building physician acceptance, establishing routine and efficient measurement, and resolving competing clinical demands and work flow impediments.

Routinely measuring and reporting pneumococcal vaccination among immunosuppressed rheumatology outpatients: the first step in improving quality.

Objective: The Centers for Disease Control (CDC) recommends pneumococcal vaccination for immunocompromised patients. Data suggest that rates of vaccination in this population are not optimal. To support continuous quality improvement efforts, we electronically measured vaccination status among rheumatology outpatients over time.