Date of Conferral
8-7-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Margaret Harvey
Abstract
Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% approval rate. Approval time averaged 7-14 days or longer. Planning required 8–10 weeks, followed by a 4-week implementation and evaluation period. The intervention included previsit insurance verification, GLP-1 eligibility screening, standardized documentation, same-day PA submission when appropriate, 24-hour status monitoring, and a PA tracking log. Because baseline and postimplementation sample sizes differed, outcomes were reported as percentages. After implementation, 7 of 12 requests (58.3%) were approved, 3 (25.0%) were denied, and 2 (16.7%) remained pending. The mean approval time for approved requests was 3.3 days. Despite unequal sample sizes and limited baseline timing data, percentage comparisons provided a transparent outcome evaluation. The project established a standardized workflow, an eligibility checklist, documentation template, and tracking tool. Findings support continued use of the proactive GLP-1 PA workflow, monthly payer specific refinement, electronic health record integration, improved care coordination, reduced medication access delays, and more equitable access to evidence-based treatment.
Recommended Citation
Etape, Ebote, "Standardized Proactive GLP-1 Prior Authorization Workflow" (2026). Walden Dissertations and Doctoral Studies. 20593.
https://scholarworks.waldenu.edu/dissertations/20593
