Quality Improvement of Procedural Services in Family Medicine Residency Clinics

Background: Performing common procedures in our family medicine residency clinics is often a difficult and inefficient process. A 2008 Society of Teachers of Family Medicine consensus statement on procedural training found higher job satisfaction and better financial compensation for family practitioners who performed procedures. Patient satisfaction is likely increased when minor procedures are able to be performed by their primary clinician. This would suggest a disconnect between the known benefits of providing procedural services and the ability of our residency clinics to provide those services in an efficient manner. Purpose: To assess clinician and staff comfort with performance of common family medicine procedures and implement an intervention to improve the efficiency of procedure performance in the clinic setting. Methods: Phase 1: Preintervention survey was distributed to physicians, residents and staff at Aurora Health Care’s family medicine residency clinics. Survey evaluated comfort level of providers in performing common procedures and identifying proper equipment needed to perform procedures. Data was compiled in Microsoft Excel; statistical analysis was performed using ordinal logistic and binary regression. Phase 2: Instructional procedures manual was created for 15 common procedures and provided to clinics. Phase 3: Postintervention survey was distributed after providers had access to procedures manual. Results: Presurvey data revealed the majority of respondents felt neutral about their ability to perform procedures. However, residents felt more comfortable performing procedures than faculty. Postsurvey data revealed that a minority of respondents were aware of or used the procedures manual. Conclusion: Our study demonstrated that a targeted intervention to improve the efficiency of procedure performance in the clinic setting was not well utilized. Therefore, a definitive conclusion about the ability of the intervention to improve the efficiency of procedure performance was not able to be made. Future areas of focus include better promotion of and ease of access to any selected intervention to improve efficiency of procedure performance