Advancing Health by Addressing Missed Opportunities in Primary Care

Project Description Narrative:

Each day, thousands of patients visit a health care provider. Any of these visits are opportunities for the provider to screen for problems with one or all of the leading health indicators (LHIs), or to do a counseling intervention. Unfortunately, many of these opportunities are missed. In a recent study at a single institution, there were significant deficits in the quality of care provided to children. Only 67% of the indicated care was provided for the acute medical problems. Even greater deficits occurred in the care of chronic medical conditions (53% of indicated care provided) and preventive care (41% of indicated care). Yet other studies have shown that patients want to discuss these issues with their providers, and that effective conversations about these issues can improve healthy behavior.

This program will develop the foundation and tools needed to implement a new mechanism for observing resident interactions and provide targeted feedback about missed opportunities. This project is the next necessary step for a comprehensive citywide effort to improve residents’ screening and communication about the LHIs.