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Quality improvement initiatives in rheumatology

an integrative review of the last 5 years

Liu, Lucy H.; Choden, Sonam; Yazdany, Jinoos

Current Opinion in Rheumatology: March 2019 - Volume 31 - Issue 2 - p 98–108
doi: 10.1097/BOR.0000000000000586

Purpose of review We reviewed recent quality improvement initiatives in the field of rheumatology to identify common strategies and themes leading to measurable change.

Recent findings Efforts to improve quality of care in rheumatology have accelerated in the last 5 years. Most studies in this area have focused on interventions to improve process measures such as increasing the collection of patient-reported outcomes and vaccination rates, but some studies have examined interventions to improve health outcomes. Increasingly, researchers are studying electronic health record (EHR)-based interventions, such as standardized templates, flowsheets, best practice alerts and order sets. EHR-based interventions were most successful when reinforced with provider education, reminders and performance feedback. Most studies also redesigned workflows, distributing tasks among clinical staff. Given the common challenges and solutions facing rheumatology clinics under new value-based payment models, there are important opportunities to accelerate quality improvement by building on the successful efforts to date. Structured quality improvement models such as the learning collaborative may help to disseminate successful initiatives across practices.

Summary Review of recent quality improvement initiatives in rheumatology demonstrated common solutions, particularly involving leveraging health IT and workflow redesign.

Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA

Correspondence to Jinoos Yazdany, MD, MPH, Division of Rheumatology, Department of Medicine, University of California, 1001 Potrero Ave, SFGH 30, San Francisco, CA 94110, USA. Tel: +1 415 370 9393; e-mail:

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