Integrating Education and Practice Change to Improve Obesity Management: A Multisite Quality Improvement Initiative
Carley Yawn, Sejal Desai, Joseph Kim, Paige Langdon, Robin Black, Sarah NislyOBJECTIVE
Despite evidence-based guidelines and expanding pharmacologic treatment options, obesity remains underdiagnosed and undertreated, reflecting limited clinician confidence, workflow constraints, and gaps in patient engagement. This study evaluated a multisite quality improvement (QI) initiative integrating continuing medical education (CME) and practice-level interventions in obesity diagnosis, multimodal care planning, and antiobesity medication (AOM) prescribing.
RESEARCH DESIGN AND METHODS
A prospective, multisite QI initiative was conducted from March 2023 to February 2024. Participating practices implemented interventions targeting clinician knowledge/skills, systems/workflow redesign, and patient engagement using Plan-Do-Study-Act cycles. Educational activities included case-based learning, implementation tools, and performance feedback. Sites abstracted deidentified electronic health record data at baseline and postintervention to assess the study outcomes, CME before and after assessments measured educational outcomes, and qualitative data from QI sessions and site feedback were analyzed thematically. Patient-level outcomes were analyzed separately from the national CME learner outcomes.
RESULTS
Baseline data included 769 patients, and postintervention data included 699 patients. Improvements were observed in obesity diagnosis documentation (78.9% to 89.2%), multimodal care planning (28.8% to 54.2%; P < 0.05), and AOM prescribing (48.4% to 64.3%). The proportion of patients achieving weight loss within the prior 6 months increased from 46.0% to 70.7% (P < 0.05). Educational activities reached 18,799 clinicians nationally and improved knowledge and competence. Qualitative findings highlighted increased clinician comfort discussing weight and greater use of workflow tools.
CONCLUSIONS
This structured QI initiative was associated with improvements in obesity care processes and weight outcomes, supporting the feasibility of scalable CME, workflow, and patient engagement tools, while recognizing the limitations of a voluntary, uncontrolled design.