Verona and Milwaukee Clinics Win 2008 James E. Davis Quality Awards

Projects to improve screening for cervical cancer and osteoporosis were winners of the eighth annual James E. Davis Quality Improvement Award. The awards were presented on October 29, 2008, during the Renner/Hansen ceremony and reception, to:

• The UW Health Verona Clinic for its project, "Implementing Best Practices in Cervical Cancer Screening"; and
• The Aurora UW Medical Group (AUWMG) Family Practice Center for its project, "Improving Osteoporosis Screening Rates."

A Single Protocol for Cervical Cancer Screening

The Verona Clinic project aimed to implement a uniform method to screen for cervical cancer in low-risk women at the clinic. This would not only increase effectiveness of screening, but would also help nursing staff better predict room setup, thereby using time and supplies more efficiently.

To accomplish this, the team, led by second-year medical student Adrian Tabares and Ann Evensen, MD, first reviewed the current literature on best practices for cervical cancer screening.

The team then performed a chart review to determine what percentage of patients screened between January through September 2007 were at high risk for cervical cancer, audited the abnormal pap smears from this same time period, and surveyed clinicians to identify current screening practices.

Finally, the team worked with faculty to agree on a single cervical cancer screening protocol, and worked with the nursing staff to standardize room setup accordingly.

A follow-up six months later showed no change in the frequency of abnormal pap smears, and that clinicians and staff improved adherence to two of the three protocol components.

Improving Osteoporosis Screening Rates

The AUWMG Family Practice Center project aimed to increase osteoporosis screening rates for women aged 65 and over from 32% to 40%. Osteoporosis screening for eligible women is recommended by the National Osteoporosis Foundation, and as of 2007, is a Healthcare Effectiveness Data and Information Set (HEDIS) requirement for quality care.

First, the team, led by third-year resident Danielle Tonelli, DO, held two meetings in October 2007 to identify issues, goals, barriers, and proposed solutions related to the project.

The team then developed a comprehensive plan-based on electronic medical record safeguards, enhanced communication, updated practice guidelines, and optimized patient education and appointment scheduling-to improve screening rates at the clinic. The plan was rolled out to all clinicians and staff in a briefing meeting at the end of October 2007.

A follow up three months later showed that screening rates had increased to 50%, exceeding the project's original goal by 10%. Data on screening rates is collected and reported monthly, and as of October 1, 2008, the clinic had a screening rate of 47.4%.

About the Davis Award

The James E. Davis Award for Quality Improvement was established in 2001 to recognize outstanding quality projects in the department. Each year, awards are made in two categories: resident-led projects and other department group projects. Each winning team receives a plaque and a $500 cash award.