Current Topic...

A Quality Improvement Project to Inform Chiropractic Clinical Decision Making

by Metz, Douglas

Abstract: Chiropractors have used X-ray examinations as a common practice in the diagnosis of musculoskeletal and spine-related conditions; however, evidence indicates X-ray exams are not necessary in the vast majority of cases. American Specialty Health (ASH) implemented a quality improvement project to educate doctors and manage the reimbursement for unnecessary X-ray exams. Key causal drivers identified by root cause analysis included lack of evidence-based guidelines, lack of evidence-based education for practitioners, lack of practitioner knowledge and commitment to evidence-based practices, and lack of practitioner buy-in about changing entrenched healthcare decision making. Practices implemented to address root causes included guidelines development, practitioner education, utilization management oversight, credentialing and practice protocol oversight, and quality management oversight. Results include reducing the number of unnecessary X-ray exams from a baseline of 72% of patients receiving an x-ray exam to a current state of 9%, without negatively affecting the quality or outcomes of treatment provided. The 13-year project has won national awards for changing doctor behavior while maintaining a safe and highly satisfied patient population.

learn more…

 

Add a Comment