While Patient is in the Waiting Room
- Hang informative posters and display fliers on each of the measures
- Ask the patient to complete a questionnaire to provide information on screening history
During Patient Check-In
- The front desk reviews alerts for prevention services that are due.
- Question patient about preventive care that may have been performed elsewhere (such as a flu shot, mammogram or colonoscopy).
- Note response and question when and where if the answer is yes.
- Highlight services that are needed and provide educational materials.
- Make note of materials provided.
- Use preventive care flow sheets and reminder stickers
During Visit
- Physician questions patient about family history and previous screening.
- Let patient know the benefits of screening
- Schedule screening before the patient leaves the office.
- Make note of the Quality-Data Code (QDC) Category for the action performed.
Refer to 2012 Physician Quality Reporting System Measures List for specifications about the prevention services that you are providing.
Examples:
- Preventive Care and Screening: Colorectal Cancer Screening - Percentage of patients aged 50 to 75 years who received the appropriate colorectal cancer screening.
- Preventive Care and Screening: Screening Mammography - Percentage of women aged 40 to 69 years who had a mammogram to screen for breast cancer within 24 months.
- Preventive care and Screening: Tobacco Use: Screening and Cessation Intervention - Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user
- Preventive Care and Screening: Pneumonia Vaccination for Patients 65 years and Older - Percentage of patients aged 65 years and older who have ever received a pneumococcal vaccine
- Preventive Care and Screening: Infulenza Immunization - Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 of the one-year measurement period who received an influenza immunization OR who reported previous receipt of an influenza immunization
- Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL) Test Performed AND Risk-Stratified Fasting LDS - Percentage of patients aged 20 to 79 years whose risk factors have been assessed and a fasting LDL test has been performed AND who had a fasting LDL test performed and whose risk-stratified fasting LDL is at or below the recommended LDL goal
- Hypertension (HTN): Controlling High Blood Pressure - Percentage of patients aged 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose BP was adequately controlled (<140/90 mmHg)
Post Visit
- The provider reviews what has been done regarding prevention services.
- Staff assists the patient in scheduling follow up screening, or providing supplies for procedures done at home, such as FOBT/FIT screening.
- Document education provided, orders, counseling, referrals, or prescriptions given.
- Provide a visit summary, including prevention care recommendations and follow-up appointments, to the patient.
- Provide a reminder card for future services scheduled
Tips for Consistent Follow-Through
- Create a standing order for vaccinations as a way to ensure all eligible patients are properly vaccinated. As staff perform and document vitals and the patient history, a standing order would allow administration of needed vaccines. Staff should be comfortable discussing the provider’s position on vaccines (e.g., “All Dr. X’s patients are vaccinated unless there is a specific medical reason to not vaccinate. The vaccines can save your life—and if you’re around children, may prevent you from spreading disease to them. The pneumococcal vaccine protects against the bacterium that causes middle ear infection, sinus infections, pneumonia, blood stream infections and meningitis. These diseases occur year-round, unlike influenza.”) Vaccines or medical exclusions are documented.
- Assign staff to ask if patient has questions after reading brochures or other educational materials.