Implementation of disease activity in a typical academic rheumatology clinic can be achieved by standardizing workflow using a simple paper form, according to a recent study. Researchers used Plan-Do-Study-Act (PDSA) methodology over 2 cycles with a goal of increasing provider measurement of disease activity during all rheumatoid arthritis (RA) patient visits. In PDSA cycle 1, they implemented a paper-based form to help providers assess disease activity. PDSA cycle 2 included the creation of separate patient and physician forms for collection of information, identification of patients prior to their clinic visit, and incorporation of medical assistants into the workflow. They found:

• The first PDSA cycle improved the number of RA patients with documented disease activity measures from 24% over a 4-week period, to an average of 44% over an 8-week period.

• The second PDSA cycle showed a sustained and dramatic improvement, with 85% of patients having a disease activity measure recorded over a 27-week period.

Citation: Bays A, Wahl E, Daikh DI, Yazdany J, Schmajuk G. Implementation of disease activity measurement for rheumatoid arthritis patients in an academic rheumatology clinic. [Published online ahead of print August 15, 2016]. BMC Health Serv Res. doi:10.1186/s12913-016-1633-x.