This quality improvement project aims to modify an existing weight management clinical pathway within an internal medicine clinic. This modified program was comprised of a multi-visit format with visits grouped into two groups of four visits centering around the MD/NP and dietician. This multi-visit format was comprised of both virtual phone/video visits as well as in-person visits throughout the program. In addition to these changes a psychology post-doctoral fellow was appointed as a gate keeper to patients entering the revised program. The fellow’s responsibilities included motivational interviewing, gathering weight history, establishing contextual psychosocial factors, and providing suggestions to the rest of the team for subsequent visits. Sample: The population used for this study included the adult population of the URMC internal medicine clinic. This project is on-going at this time and patient demographics will be updated at its conclusion. Project design: The current design for this study includes a multi-visit format involving different internal medicine providers. Patients are referred to the program either by their PCP or through a self-referral. Once the patient is enrolled in the program, they meet with the psychology fellow to determine readiness and ability to attend to the programs aims using history and screeners. If approved they move on to seeing alternating providers (MD/NP or dietician) in three future visits. Case management will check in with the patients after this set of four visits. If the patient is interested in continued visits four additional visits will be scheduled with alternating providers. If the patient is not approved the patient is directed back to their PCP with recommendations and motivational interviewing skill suggestions to assist the patient in motivational enhancement prior to re-referral of the patient. Data collection: Data was collected from provider participants using an anonymous survey through survey monkey. Responses were coded and analyzed using Nvivo and thematic analysis. Patient data was also examined such as weight loss, quality of life improvement, and completed patient participants. Conclusion: Preliminary results suggest that providers within the program find the modified program helpful and beneficial. Patient data also suggests successful outcomes measured by weight loss, completion of the program, and enhanced quality of life.
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