Quality Improvement Methods for Improving Diabetic Retinopathy Screening Rates at a Large Academic Medical Center and...

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Diabetic retinopathy (DR) screening is vital for early detection and prevention of vision loss in diabetic patients.
• Current DR screening rates fall short of the Healthy People 2030 target, with significant care gaps identified in Chicagoland (49.7% at Northwestern Medicine).

Purpose of the Study:

• To implement and evaluate a quality improvement initiative aimed at increasing diabetic eye exam screening rates.
• To identify and address barriers to diabetic eye care access and improve care coordination.

Main Methods:

• A qualitative improvement initiative utilizing Plan-Do-Study-Act cycles, root cause analysis, and data-driven decision-making.
• Interventions included point-of-care retinal imaging, previsit questionnaires, practice advisory tools, clinical decision support, and community health worker integration.
• Focus on improving patient access through same-day exam availability, seamless referrals, and targeted outreach.

Main Results:

• DR screening rates increased significantly from 49.7% to 57% over a 22-month period.
• The initiative successfully improved patient access and care coordination, addressing identified barriers to diabetic eye exams.
• Demonstrated effectiveness of integrated interventions in closing screening gaps.

Conclusions:

• Quality improvement initiatives incorporating multifaceted interventions can substantially elevate diabetic eye exam screening rates.
• Enhancing patient access and care coordination are key strategies for improving DR screening adherence.
• The study provides actionable interventions and lessons learned for healthcare systems seeking to optimize diabetic eye care and patient outcomes.