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• W4313204142 abstract "The World Health Organization describes quality health care as effective, safe, people-centered, timely, equitable, integrated, and efficient.1 Quality improvement measures attempt to realize these ideals by improving the overall health of the population, enhancing patient experiences and outcomes, and reducing the overall cost of care. In plastic surgery, quality improvement endeavors are lagging compared with other surgical specialties. By employing a broadly applicable framework, such as the observe–orient–decide–act loop,2 plastic surgeons can perform quality improvement studies easily and increase quality improvement in plastic surgery. We applied this cycle in a simple quality improvement study concerning our body contouring consultations to yield tangible results (Fig. 1).Fig. 1.: Representation of the observe–orient–decide–act loop.2 Observation. We found that 42% of patients (26 of 62) presenting for consultation for body contouring in the past year were not surgical candidates. This led to increased wait times, patient frustration, and significant monetary losses. Orientation. This observation allowed us to realize that our resources were being used in a suboptimal way, which can be explained by a lack of communication among plastic surgeons, referring physicians, and patients. We aspired to increase clinical efficiency and improve the experience of our patients. Decision. We designed a screening questionnaire (Fig. 2) and distributed it to all patients referred to us before booking an appointment in clinic. The questionnaire contains a concise list of objective criteria patients must satisfy to be eligible for body contouring surgery, such as having bariatric surgery more than 12 months ago, having a body mass index of less than 35, having 6 months of weight stability, and being a nonsmoker.3 We also created a standardized response sheet that we send to patients who do not meet criteria with resources to help them meet these milestones.Fig. 2.: Example of the screening questionnaire sent to patients. Action. Since implementation of the questionnaire, we have only offered consultation to patients who have met the described criteria. All the patients we have seen in clinic since the implementation of the questionnaire have met surgical criteria and have been booked for body contouring procedures. A total of 37% of patients (16 of 43) returning the questionnaire did not meet surgical criteria. We send the questionnaire to all patients referred to us seeking body contouring. Patients who return a completed questionnaire and satisfy the presurgical screening criteria are booked for consultation. The patients who do not meet criteria receive a response sheet providing them with resources to help them reach the recommended milestones. The screening questionnaire is an example of how a simple quality improvement measure can increase clinical efficiency.4,5 Our work is not done. The four steps are designed as a loop and we are in the process of collecting additional data regarding wait times, patient experience, and cost utilization. We will adjust our quality improvement intervention according to these data, highlighting the circular nature of this methodology, requiring continuous feedback, study, and modified action. Nevertheless, even in the early stages of this initiative, our clinic and patients have already profited from this endeavor. We hope that this example of a simple quality improvement intervention improving clinical efficiency will inspire other plastic surgeons to engage in similar projects to expand the scope of quality improvement in plastic surgery. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work." @default.
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• W4313204142 date "2022-10-25" @default.
• W4313204142 modified "2023-10-03" @default.
• W4313204142 title "Body Contouring Screening Questionnaire: A Simple Quality Improvement Measure to Improve Clinical Resource Utilization" @default.
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• W4313204142 doi "https://doi.org/10.1097/prs.0000000000009754" @default.
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