Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

From Paper to Practice

Gretchen Henkel  |  Issue: June 2009  |  June 1, 2009

In the next section of the presentation, C. Kent Kwoh, MD, professor of medicine and epidemiology and chief of the Division of Rheumatology at the University of Pittsburgh, summarized the ACR’s collaboration with the National Committee for Quality Assurance and the Physician Consortium for Performance Improvement to translate the recommendations into quality and performance measures. Their efforts yielded five standards: assessment of an RA patient’s disease activity (low/moderate/high) at least once a year; assessment of the patient’s functional status; assessment and classification of disease prognosis at least once a year; TB screening for patients receiving biologic agents; and glucocorticoid management.

Dr. Kwoh said that the guiding principles for developing the standards were that they be clinically relevant, evidence based, scientifically valid, and, most important, feasible. He then demonstrated the computation of quality scores for each of the performance standards. For instance, to rate one’s performance on the standard of TB screening for RA patients receiving biologic agents, the practice would divide the number of patients who were screened for TB by the total number of patients receiving biologics. If the practice performed TB screening on 90 of the 120 patients receiving biologics, this would yield a score of 75%.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Taking the Challenge

Why is it important to implement quality measures? Asking the questions outlined in the performance standards, and tracking the answers, will boost the quality of care rheumatologists render to patients with RA, noted Dr. Newman. “My task is to take the elegant work summarized by my colleagues Dr. Saag and Dr. Kwoh and kind of bring it out to the clinic. There are skills you need to learn, steps you need to take, and processes to put into place in the clinic so that you can begin to collect these types of measures.”

Dr. Newman remarked that most rheumatologists, when asked if they deliver quality care, would answer in the affirmative. However, he also noted that many may not be able to quantify their answers with solid data. It’s important for rheumatologists to create a “culture of change,” he said, and outlined a five-step process to implement the recommendations’ quality measures into clinical practice. Dr. Newman used examples from the experience at Geisinger Medical Center as well as training workshops he conducts with colleague J. Timothy Harrington, MD, delivered with a humorous and energetic approach.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The first step, said Dr. Newman, is to commit: “The person in charge has to make it clear that this is a very, very important part of what we do for our patients.” Then it is time to get buy-in from others in the group. Typically, Dr. Newman said, 10% of a group will view change as fun and positive, 80% will be willing to listen, and 10% may resist. “Spend time with the key players,” he advised, “and focus on those who are receptive so that you can overcome inertia to change.” Next, form a team to address quality measures. The team should include all members of your microsystem, not just physicians and nurses. “The best way to meet with success is to create a team that circles around the patient. For that to happen, everybody has to be a player.” This may entail some adjustment from physicians, who tend to view the medical practice in a hierarchical way. Often, associated staff members have the best ideas, he said.

Page: 1 2 3 | Single Page
Share: 

Filed under:ConditionsMeeting ReportsQuality Assurance/ImprovementRheumatoid Arthritis Tagged with:QualityRheumatiod arthritisTreatment

Related Articles

    Rheumatology Practices Need Sharp Focus on Patient Care Safety, Quality

    February 16, 2017

    “It is not necessary to change. Survival is not mandatory.” —W. Edwards Deming For practices to survive, change is a requirement—not an option—in the rapidly evolving practice of rheumatology care. ad goes here:advert-1ADVERTISEMENTSCROLL TO CONTINUEPharmaceutical therapies are advancing quickly, opening the door for game-changing therapies in the treatment of chronic autoimmune disorders. With these advances…

    2022 PFS Final Rule for the Quality Payment Program Published

    December 2, 2021

    The ACR highlights essential information for providers for 2022 MIPS reporting in the 2022 Medicare Physician Fee Schedule Final Rule, published Nov. 2.

    Experts Offer Tips for Saving Time on Electronic Medical Records

    April 15, 2020

    ATLANTA—“Bane of our existence” and “pajama time”—the dreaded time spent at night catching up on documentation—are a couple of phrases associated with the electronic medical record (EMR). To try to ease the frustration and limit the amount of time physicians have to spend using the systems, two experts reviewed tools and tricks for Epic and…

    Rheumatology and the Patient-Centered Home

    July 1, 2010

    Is it the end of the tunnel or an oncoming train?

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences