Tiff week 7

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Unit 3: Scholarship of Application Part 1: Aim Statement and Framework

Tiffany Williams

Herzing University

NU760-8H

3/22/2025

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Unit 3: Scholarship of Application Part 1: Aim Statement and Framework

Gap recognition and filling in providing care are important to improving patient

outcomes and staying compliant with evidence-based practice. The paper outlines a practice

problem recognized in a clinical environment, formulates a problem statement, builds an aim

statement, and names a framework that will be employed in creating a scholarly project to

address the problem.

Practice Setting and Population

The practice setting is a primary care clinic with an adult patient population of 18 years

and older. The clinic provides preventive care, chronic disease management, and acute care. The

population consists of people from various socioeconomic statuses, with a high proportion of

them being underserved and at risk for chronic diseases such as hypertension, diabetes, and

cardiovascular disease. Despite evidence-based guidelines for preventive care, a conspicuous

lack of uniform implementation of recommended screenings and interventions is observed.

Description of the Problem

The identified issue is the uneven application of United States Preventive Services Task

Force (USPSTF) preventive screening guidelines, specifically cardiovascular risk factors for

illness such as hypertension and hyperlipidemia (Barry et al., 2023). Chart review and

observations revealed that the majority of patients with the routine screening due are not being

screened on time in reality. Clinic performance indicators also confirm this deficiency, where

65% of eligible patients for indicated screenings are receiving them only, falling short of the

organization's goal of 90%.

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Failure to screen per guidelines has various implications. Firstly, to delay earlier illness

diagnosis that would otherwise be better treated through intervention earlier in the disease

development process. Secondly, to develop avoidable complications like a heart attack or stroke,

which would otherwise have been avoided by earlier identification and treatment. Thirdly,

evidence-based care shortfall has been established, one of the indicators for quality health care.

Problem Statement

Processes of patient evaluation in the primary care clinic have not been consistent in

adhering to USPSTF guidelines for preventive screening until now. This results in premature

diagnosis of cardiovascular risk factors, which means unhealthy consequences that otherwise

would have been averted if there was timely intervention.

Aim Statement

This project aims to increase follow-through with USPSTF recommendations for

preventive screening, specifically cardiovascular disease risk factors, to 90% from 65% in a six-

month period. This will be achieved by having a standardized screening process, educating staff

on evidence-based recommendations, and reminders in the electronic health record system to

trigger providers at the point of patient visits.

Framework

The model to implement with this project is the Plan-Do-Study-Act (PDSA) cycle, an

Institute for Healthcare Improvement (IHI) quality improvement model. The PDSA cycle is a

rigorous cycle of testing and implementing changes at an organizational level (Roberti et al.,

2025). The PDSA cycle contains four steps:

1. Plan: Identify the problem, establish goals, and prepare for change.

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2. Do: Implement the change at a trim level.

3. Study: Compare results and determine if improvement was a consequence of the

change.

4. Act: Simplify the change from the result and implement it on an expanded scale.

PDSA cycling is suitable for this project because it allows incremental testing of

interventions such as the protocolized screening process and EHR reminders before large-scale

implementation. It also addresses the project goal of quantitatively measuring improved

screening rates. For example, at the "Plan" phase, the protocol for screening and EHR reminder

design will be developed by the team. At the "Do" phase, the interventions will be pilot-tested

with a small number of providers. The "Study" phase will entail screening rate monitoring and

provider feedback collection, and the "Act" phase will entail scaling up proven interventions.

Conclusion

The inconsistent compliance with USPSTF guidelines for preventive screening within the

primary clinic is a grave evidence-based practice deficit. By developing an obvious problem

statement, formulating an aim statement concisely, and employing the PDSA cycle as an

orienting framework, this project proposes to enhance screening rates and ultimately enhance

patient outcomes. The structured process of the PDSA cycle ensures interventions are tested,

refined, and implemented in such a way as to maximize their effectiveness and sustainability.

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References

Barry, M. J., Wolff, T. A., Pbert, L., Davidson, K. W., Fan, T. M., Krist, A. H., ... & Nicholson,

W. K. (2023). Putting evidence into practice: an update on the US Preventive Services

Task Force methods for developing recommendations for preventive services. The Annals

of Family Medicine, 21(2), 165-171.

https://www.annfammed.org/content/annalsfm/21/2/165.full.pdf

Roberti, J., Jorro-Barón, F., Ini, N., Guglielmino, M., Rodríguez, A. P., Echave, C., ... & Alonso,

J. P. (2025). Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process

Evaluation Using Normalization Process Theory. Pediatric Quality & Safety, 10(1), e788.

https://journals.lww.com/pqs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01949578-

202501000-00010