Improving Provider Education and Overall Disease Management in Patients With Polycystic Ovarian Syndrome Presenting to a Dermatology Clinic

Abstract

Aims The aim of the study was to implement a quality improvement project using the Lean Six Sigma framework of Define, Measure, Analyze, Improve, and Control in an outpatient urban medical dermatology clinic; educate providers about polycystic ovarian syndrome; increase endocrinology referrals; and optimize spironolactone use in these patients ages 12–45 years old. Background Patients with polycystic ovarian syndrome experience delays in endocrinology referrals and often suboptimally treated with spironolactone because of lack of provider understanding. Method Lean Six Sigma was used to increase provider ability to diagnose and manage polycystic ovarian syndrome, improve spironolactone dosing, and increase endocrinology referral rates through education. Pre-intervention collection occurred July to September 2023. Intervention occurred from September to December 2023. Post-intervention occurred December 2023 to February 2024. Provider surveys were collected through Microsoft Forms, and endocrinology referral rates were collected through the electronic health record, Epic. Results Improved provider understanding of polycystic ovarian syndrome was demonstrated in survey results for rate of recognition, confidence, and awareness of diagnostic criteria. Referral rates increased by 90% via SlicerDicer tool within Epic. Conclusion Through further education, dermatology providers can improve identification of the polycystic ovarian syndrome, patient outcomes, and patient experience. With identification of the need in this department, there is a platform to incorporate a multidisciplinary clinic.