Challenging Patient Motivates Quality Improvement

A continuing series highlighting Diplomates’ Quality Improvement Activities (QIA)

Dr. Joseph Fife, an ABO Diplomate who practices in St. George, UT, was recently motivated by a challenging patient to expand his scope of practice. While attending a CE lecture on Thyroid Eye Disease by another ABO Diplomate, Dr. Greg Caldwell, Dr. Fife recognized that a slide showing an image of engorged and dilated blood vessels looked very similar to a recent patient. Dr. Fife realized that, in order to help this patient, he would need to order lab work. In the past Dr. Fife would refer patients back to their PCPs for blood work, so ordering lab work was unfamiliar and uncomfortable.

Dr. Fife decided to contact Dr. Caldwell, who graciously guided him through the process of contacting a hospital-affiliated lab and encouraged Dr. Fife to contact him again once he received the lab results. Dr. Fife contacted a local lab and explained he was new to ordering lab work. He was referred to a staff person who explained their processes, walked him through which lab tests to order and directed him to the lab codes and lab results interpretation sections of their website. They additionally connected Dr. Fife with their pathologist who can be contacted for further guidance as needed. A short time later the hospital liaison personally dropped off lab requisition forms that were preprinted with Dr. Fife’s office information. Dr. Fife says he now feels empowered to order lab work himself, surrounded with knowledgeable professionals willing to guide him to work through differential diagnoses to ensure appropriate treatment and more appropriate referrals to specialists.

Dr. Fife used his desire to help his patient as motivation to step out of his comfort zone and learn a new skill. That is a common characteristic among ABO Diplomates, who continually challenge themselves to provide excellent patient care. Dr. Fife wanted to share his experience to encourage other Diplomates to reach out to other professionals – whether they’re fellow ABO Diplomates, hospital staff, or lab technicians – as we all work together to care for our patients.

If you’re looking for guidance on which lab tests to order for patients with uveitis or scleritis, you may want to watch the recorded webinar “Unraveling Intraocular Inflammation” by Dr. Erich Hinel. This webinar is free for all ABO Diplomates and Candidates and you can earn 2 hours of COPE-approved CE by taking a 20-question quiz at the completion of the webinar. Dr. Hinel also shared his lab requisition form (available on the References page of the ABO website) which can be downloaded and personalized for individual providers.