Proposal for Quality Improvement Project Titled: Improving Vitamin D Test Utilisation in Family and Community Medicine Clinics

Abstract

Background With ever-changing and evolving healthcare comes the overutilisation of laboratory tests. One of the common laboratory tests that is frequently overutilised is the vitamin D test (VDT). Although the urge to avoid unnecessary testing is primarily motivated by budgetary considerations, there are several medical factors that also support this position.

Objective The aim of this proposed quality improvement project (QIP) is to improve VDT utilisation by reducing inappropriate test ordering in a Family and Community Medicine Clinic (FAMCO). This project will reduce costs and labour while improving patient care within the healthcare organisation.

Methods Methods including lean thinking, Standards for QUality Improvement Reporting Excellence (SQUIRE 2), Model for Improvement (MFI) and the seven steps to measurements will be used to achieve the aim of this proposed QIP. A broad selection of evidence-based quality improvement (QI) methodologies and tools will be utilised. The processes to be used to understand the local context, identify the problem and design and develop effective interventions are outlined within this QIP. Also, this proposal addresses the required leadership styles, change theories, measurement and analysis processes and patient engagement and communication methods.

Results Since this is a proposal, there are no real results yet. However, simulated data are used to visualise and understand the current problem (Figure 3) and to evaluate the measurement methods (Figure 8, 9, and 10).

Conclusion The proposed QIP will use multilevel collaborative interventions to achieve the aim of reducing the number of inappropriate VDT orders. It will focus on modifying the hospital information system to change the ordering process, which is expected to yield a fundamental change and ensure sustainability. The tested approach could also potentially be applied to different tests and hospital departments.