Cardiovascular Risk Assessment in People with Rheumatoid Arthritis: Performance Improvement in an Office-Based Practice

We propose a multispecialty educational and quality improvement initiative with rheumatologists and primary care physicians (PCPs) to improve rates of cardiovascular risk screening for people with rheumatoid arthritis (RA). The intervention will begin with baseline data measurement of risk factor screening in the population of patients seen by rheumatology providers, inclusive of data obtained by the primary care provider. Baseline data will be shared with both the rheumatology practice(s) and the referring primary care practice(s) at a live workshop. Based on these baseline data, as well as a guided self-assessment of office processes in both the rheumatology and primary care offices, physicians will assess performance gaps and review effective strategies to improve screening and system processes. After participating in targeted educational interventions and quality improvement training, the rheumatologists, in coordination with primary care providers, will deploy quality improvement projects with the two-part aim of increasing cardiovascular screening rates in people with RA and improving corresponding clinical measures (specifically glycemic control, blood pressure, lipids, and smoking.). A subsequent measurement examining both screening rates and improvement in measurable risk factors will help practices to assess their success in meeting their quality improvement goals, and put them on a course - with support from the developed necessary education, tools and resources - to continuous quality improvement.