Analysing the effect of multidisciplinary teams to address preventive healthcare gaps in a rural teaching clinic: a quality improvement project.

Abstract

Preventive care decreases the risk of illness, disease and death, yet patient adherence to preventive care is low, calculated to be around 5%, and rural residents are suspected to have even lower rates compared with urban patients. Despite continually updated guidelines and recommendations for screenings and preventive care, delivery of care to rural patients is difficult, and a deficit exists. This project aimed to use multidisciplinary teams at a teaching rural health clinic to close five preventive care gaps: lung cancer screening, colon cancer screening, Shingrix vaccination, osteoporosis screening and hepatitis C screening by 10% in the rural community.An electronic medical record (EMR) analysis was used to identify and prioritise preventive care gap deficiencies, and quality improvement methods integrating student physicians were used to integrate and optimise care gap closures into the daily routine of clinic staff.After three intervals of the project period, a 19% increase was achieved in lung cancer screening, a 49% increase in colon cancer screenings and 63% and 9% in osteoporosis and hepatitis C screenings. Additionally, medical providers had a change in practice management as a direct result of intentional attention to preventive care gaps. The Shingrix vaccination project needed to be stopped due to the availability of the vaccine.By using an EMR and a working relationship between staff, nursing, physicians and students, health disparities in a rural community were decreased.