SAT682 Improving Obesity Counseling Rates In An Academic Internal Medicine Clinic: A Quality Improvement Study
Authors: Mathew Anoopa , Asif Javaria , Samrah David , Rai Kelash , Ramakrishna Jahanavi , Ilyas Hasan , Tegeltija Vesna 
Published: October 2023

Abstract
Disclosure: A. Mathew: None. J. Asif: None. D. Samrah: None. K. Rai: None. J. Ramakrishna: None. H. Ilyas: None. V. Tegeltija: None.
Introduction: Obesity is a chronic disease that affects more than 40% of the population in the United States. The prevalence of severe obesity doubled in the past two decades. PCP are usually the first to screen patients for obesity. Only 55% of adults with obesity were reported to have received the diagnosis of obesity and less than a third of the patients followed up for an obesity-specific visit. The management of obesity is multifactorial with lifestyle modifications, pharmacological and psychological therapies. In our academic clinic, there was a gap in satisfactory obesity counseling, which addresses lifestyle modifications and adjunctive pharmacological therapies. Addressing this gap with an obesity-specific visit helps clinicians to discuss available options to manage obesity. Improvement in body weight is linked with improved control of hypertension, diabetes, and heart disease leading to improved health outcomes. Aim: To improve obesity counseling rates in an academic clinic by 25% in 3 months. Method: We used the IHI model of improvement using the plan-do-study-act framework to test changes on a small scale and guide the quality improvement study. After the IRB exemption was granted, a thorough chart search for the last 3 months was done to calculate a baseline obesity counseling rate. A root-cause analysis was completed with multi-disciplinary input from faculty, clinic staff, and residents, and several existing barriers that preclude satisfactory obesity counseling were identified. Proposed interventions corresponding to each root cause were plotted on an impact effort matrix. Interventions with the least effort and the most impact were selected as proposed solutions. These included creating a short education session on obesity management and creating an obesity counseling template. Post-intervention, the obesity counseling rates and use of the template were recorded on a run chart. Results: Satisfactory obesity counseling prior to intervention was 32%. The first PDSA cycle post-intervention showed an improvement in the obesity counseling rates to 56%. About 20% of the clinic notes for the counseled patients used the proposed template. About 8% of the counseled patients agreed to a separate obesity-specific visit. Next steps: We noted an overall improvement in the obesity counseling rates after our interventions. However, we noticed there were instances of vague or unclear documentation for obesity counseling. Our next intervention will be to provide an infographic handout as a visual reminder for residents, which highlights key components of obesity counseling. This includes identifying obesity-associated health conditions, limitations to lifestyle modifications, social determinants of health, and indicated or contraindicated pharmacological options. We will also monitor the number of patients agreeing to an obesity-specific visit after the second PDSA cycle.
Presentation: Saturday, June 17, 2023