Evaluating a Quality Improvement Program for Cervical Cancer Screening at an Urban Safety Net Clinic.

This article evaluates a quality improvement program for improving guideline-consistent cervical cancer screening practices in an urban safety net clinic. Quality improvement initiatives that combine policy with practice are particularly timely in light of the alignment of cervical cancer screening guidelines released in 2012 by the most influential national organizations. A descriptive comparison design was employed using the Healthy People 2020 target of 93% screened according to guidelines. Provider-, patient-, and workflow-based strategies included (1) addition of a clinical decision support system, (2) provider educational outreach, (3) patient reminder letters, and (4) development of a clinic procedure manual. Through the application of an established quality measurement tool, three quality indicators were measured: screened according to evidence-based guidelines, not screened, and screened more frequently than recommended. Data from the sample (N = 1,032) were collected at baseline and 12 months postimplementation. Each quality indicator category was significant at follow-up. Patients screened according to guidelines nearly doubled while the number of underscreened patients was reduced by nearly half. Similarly, there was a threefold decrease in patients screened more frequently than recommended. Clinical administrators, quality improvement specialists, and health care providers in primary care settings can use the strategies implemented in this study as a starting point for continuous quality improvement initiatives for cervical cancer screening.

Transforming psychiatric mental health nursing education with team based learning.

The aim of this study was to evaluate the effect of the team-based learning (TBL) instructional approach on learning outcomes in an undergraduate psychiatric mental health (PMH) nursing course. An uncontrolled, before and after design was employed. Data were collected over eight consecutive semesters (N=347) before and after implementation of TBL. Two variables were selected for comparison before and after implementation: scores on PMH portion of the Evolve® practice exit examination and time (in hours) students reported preparing for class. After implementation, students scored higher on the PMH practice exit examination and reported increased study time. Qualitatively, students reported enjoying working in teams despite the increased study time required with the TBL method.