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.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Bays A,Wahl E,Daikh DI,Yazdany J,Schmajuk Gdoi
10.1186/s12913-016-1633-xsubject
Has Abstractpub_date
2016-08-15 00:00:00pages
384issue
aissn
1472-6963pii
10.1186/s12913-016-1633-xjournal_volume
16pub_type
杂志文章abstract：BACKGROUND:Bladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers. The objective of this study was to characterize the use of health-care services and costs associated with BC among patients who underwent radical cystectomy (RC) in the province of Quebec. METHODS:We conducted a descrip...
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