Sinusitis Treatment Guideline Adherence in the E-Visit Setting: A Performance Improvement Project

Area of Science:

• Healthcare Quality Improvement
• Infectious Disease Management
• Clinical Practice Guidelines

Background:

• Healthcare providers exhibit poor adherence to treatment guidelines for upper respiratory infections.
• Antibiotic prescribing for acute bacterial rhinosinusitis (ABRS) is a particular area of concern.
• This highlights a need for interventions to improve guideline adherence.

Purpose of the Study:

• To evaluate interventions aimed at improving adherence to ABRS clinical practice guidelines.
• Focus on patients managed through e-visit settings.
• Assess the impact of specific interventions on provider behavior.

Main Methods:

• A quality improvement project utilizing a pre- and post-intervention design.
• Retrospective analysis of electronic health records (EHR) for ABRS diagnoses.
• Interventions included provider feedback reports, updated guideline education, and clinical decision support reminders.

Main Results:

• Adherence to ABRS guidelines improved by 3.3% post-intervention.
• Pre-intervention adherence was 95.25%, increasing to 98.4% post-intervention.
• Demonstrated effectiveness of combined educational and decision support interventions.

Conclusions:

• Educational interventions and clinical decision support effectively improve adherence to ABRS guidelines in e-visits.
• These quality improvement strategies can reduce unnecessary antibiotic prescribing.
• Significant implications for optimizing antibiotic stewardship in outpatient settings.