Date of Conferral

2014

Degree

Doctor of Nursing Practice (DNP)

School

Health Services

Advisor

Alice Conway

Abstract

Preventive quality ordering is a provider intervention aimed at disease prevention through the ordering of industry-recommended health maintenance tests. This pilot study evaluated the effectiveness of provider mentoring/coaching to improve preventive quality ordering using the 2014 Agency for Healthcare Research and Quality best practice preventive clinical services guidelines. Literature indicates provider inconsistency in preventive and quality ordering as the primary cause of disparate health outcomes. Guided by theories of modeling and role-modeling, as well as the theory of cognitive continuum, this pilot study offered provider mentoring/coaching to encourage timely preventative quality ordering. Routinely monitored historic provider practice patterns in a proprietary database were analyzed; 10 providers with the lowest ordering patterns were identified for participation. Mentoring/coaching interventions were provided to improve preventive quality measure ordering. This process included a review of the 2014 Adult Healthcare Effectiveness Data and Information Set documentation criteria, a preventive measures clinical checklist, medical record preparation guidance, clinical shadowing, and post-training discussions. Following the pilot, a 5-person subject matter expert panel of key organizational leaders used on-site observations and standardized semi-structured interviews to evaluate the usefulness of mentoring/coaching and the developed documents to improve timely quality ordering. This small-scale pilot study (a) improved providers' awareness of quality ordering through peer mentoring, communication, and training; and (b) provided a platform for future initiatives. A larger follow-up study will allow healthcare leaders/providers to address disparate health outcomes, and patients will likely benefit from optimal delivery of preventive care.

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