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Sunset Terrace

ANNUAL GYN EXAMS
Sunset Terrace Family Health Center

Project Background

Project Name: Annual GYN Exams

HIV Caseload: 275

Rationale for Selections: HIVQUAL performance results from 1997-98 indicated that the percentage of HIV-infected women receiving an annual GYN was 77%.

Team Members:

  • Emily Brown (Team Leader)
  • Julio Rivera, Jr., HIV Program Director
  • Edwin Calderon, PA, Provider
  • Yolanda Grandison, RN
  • Portia Prescott, RN
  • Jeanette Lopez, PSA, Scheduling Staff Supervisor

Success Story

Improvement Goal: To increase the percentage of HIV-infected women receiving an annual GYN to 90% by the end of calendar year 1999

Methodology: The team focused on two possible causes for the problem: primary care providers failing to refer patients for GYN exam, and insufficient availability of GYN appointments. After investigating these two areas further, the team made the following discoveries:

  • A random sample of charts revealed that primary care providers referred only 88% of patients to GYN in one year.
  • The average wait time for new GYN appointments was 6-8 weeks, and 2-4 weeks for revisits.

Changes Tested: The team selected the following interventions:

  • To address provider referrals, the nursing staff implemented a flow sheet to be used at each visit which would function as a reminder to providers to make referrals, if needed.
  • To open up more GYN appointment slots for HIV+ women, two sessions were reserved every other week for HIV+ women only.

Baseline and Follow-up Data: The GYN exam rate increased from 77% (HIVQUAL performance resultsb 1997-98) to 89% (1/1/99 to 12/31/99).

Summary

Lessons Learned: Factors which helped us to do our improvement projects:

  • Leadership support
  • Resources from the main institution (help with chart reviews, etc.)

Factors which hindered us in doing our improvement projects:

  • Limited flexibility from overall administration of the facility to allow changes, even on a limited basis

By pooling resources, ideas, and abilities, we were able to enact a significant change in our services for the benefit of our patients.

Next Steps: Based on staff feedback, the flow sheet reminder intervention was eliminated, and a system of reminder calls to women was added. The HIV+ GYN sessions are continuing.

For more information, please contact:

Michael Bosket, MS, MBA
Special Care Immunology Services Administrator
Submission Date: 2000
mbosket@lmcmc.com

Sunset Terrace Family Health Center
Lutheran Medical Center
514 49th Street
Brooklyn, NY 11220
(718) 431-2610 (phone)
(718) 436-7810 (fax)