As part of monitoring adherence to the Clinical Practice Guidelines (CPGs) for the treatment of schizophrenia, it was identified that the adherence rates for measuring waist circumference were significantly lower than the other metabolic monitoring components.
Improving the adherence rates for measuring waist circumference was selected as an opportunity for improvement given the research base showing a high rate of premature mortality in people with schizophrenia due to cardiovascular disease.
Early recognition of the indicators for metabolic syndrome enables interventions to be targeted that can help delay or reverse the effects, thus improving overall health outcomes. There were a number of key lessons learned throughout this initiative. The initial implementation of metabolic monitoring within the hospitals Electronic Medical Record (EMR) was not sufficient with regards to achieving and maintaining high levels of adherence for all components of metabolic monitoring.
Additional technical fixes were also not sufficient in supporting the desired improvements. Data available through our EMR was leveraged to support learning from our variation, leveraging the use of a statistical approach. Most importantly, this initiative underscored the need for peer-to-peer engagement and the value of transparency around adherence results to fostering constructive dialogue, learning and accountability.