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Abstract

Background: Obesity is a preventable epidemic and costs the United States $200 billion annually. The leading causes of death are linked to obesity.

Local Problem: In a chart review, 53% of patients at a northeast Louisiana primary care clinic were obese. However, none were offered comprehensive lifestyle intervention. The aim was to increase the percentage of patients with BMI < 30 kg/m2 to 60% over 8 weeks.

Methods: A rapid-cycle quality improvement initiative was implemented using four Plan-Do-Study-Act cycles over 8 weeks. Each cycle produced tests of change related to screening, patient and team engagement, and assessing effective care. Run charts and aggregate tables were used to analyze data to evaluate the impact of each test of change.

Interventions: Screenings assessed cause and risk factors of obesity. Brief Negotiations assessed readiness to change. Patients were engaged using the Rx for Health tool to make lifestyle modifications. Effective care was evaluated through a case management log. Team engagement included huddles, emails and texts, and a lunch meeting.

Results: Obesity screening increased by 79% and addressing obesity increased by 97%. Obesity management in the primary care setting improved by 16% as patients chose comprehensive lifestyle interventions to obtain a cumulative patient weight loss of 62.8 pounds.

Conclusions: Frequent follow-up visits promoted compliance and produced financial benefits for the clinic. Project sustainability is possible with minimal start-up costs, the increase in billable appointments, and the growing obesity population.

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