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Unit 3: Scholarship of Application Part 1: Aim Statement and Framework
Tiffany Williams
Herzing University
NU760-8H
3/22/2025
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Unit 3: Scholarship of Application Part 1: Aim Statement and Framework
Gap recognition and filling in providing care are important to improving patient
outcomes and staying compliant with evidence-based practice. The paper outlines a practice
problem recognized in a clinical environment, formulates a problem statement, builds an aim
statement, and names a framework that will be employed in creating a scholarly project to
address the problem.
Practice Setting and Population
The practice setting is a primary care clinic with an adult patient population of 18 years
and older. The clinic provides preventive care, chronic disease management, and acute care. The
population consists of people from various socioeconomic statuses, with a high proportion of
them being underserved and at risk for chronic diseases such as hypertension, diabetes, and
cardiovascular disease. Despite evidence-based guidelines for preventive care, a conspicuous
lack of uniform implementation of recommended screenings and interventions is observed.
Description of the Problem
The identified issue is the uneven application of United States Preventive Services Task
Force (USPSTF) preventive screening guidelines, specifically cardiovascular risk factors for
illness such as hypertension and hyperlipidemia (Barry et al., 2023). Chart review and
observations revealed that the majority of patients with the routine screening due are not being
screened on time in reality. Clinic performance indicators also confirm this deficiency, where
65% of eligible patients for indicated screenings are receiving them only, falling short of the
organization’s goal of 90%.
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Failure to screen per guidelines has various implications. Firstly, to delay earlier illness
diagnosis that would otherwise be better treated through intervention earlier in the disease
development process. Secondly, to develop avoidable complications like a heart attack or stroke,
which would otherwise have been avoided by earlier identification and treatment. Thirdly,
evidence-based care shortfall has been established, one of the indicators for quality health care.
Problem Statement
Processes of patient evaluation in the primary care clinic have not been consistent in
adhering to USPSTF guidelines for preventive screening until now. This results in premature
diagnosis of cardiovascular risk factors, which means unhealthy consequences that otherwise
would have been averted if there was timely intervention.
Aim Statement
This project aims to increase follow-through with USPSTF recommendations for
preventive screening, specifically cardiovascular disease risk factors, to 90% from 65% in a six-
month period. This will be achieved by having a standardized screening process, educating staff
on evidence-based recommendations, and reminders in the electronic health record system to
trigger providers at the point of patient visits.
Framework
The model to implement with this project is the Plan-Do-Study-Act (PDSA) cycle, an
Institute for Healthcare Improvement (IHI) quality improvement model. The PDSA cycle is a
rigorous cycle of testing and implementing changes at an organizational level (Roberti et al.,
2025). The PDSA cycle contains four steps:
1. Plan: Identify the problem, establish goals, and prepare for change.
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2. Do: Implement the change at a trim level.
3. Study: Compare results and determine if improvement was a consequence of the
change.
4. Act: Simplify the change from the result and implement it on an expanded scale.
PDSA cycling is suitable for this project because it allows incremental testing of
interventions such as the protocolized screening process and EHR reminders before large-scale
implementation. It also addresses the project goal of quantitatively measuring improved
screening rates. For example, at the “Plan” phase, the protocol for screening and EHR reminder
design will be developed by the team. At the “Do” phase, the interventions will be pilot-tested
with a small number of providers. The “Study” phase will entail screening rate monitoring and
provider feedback collection, and the “Act” phase will entail scaling up proven interventions.
Conclusion
The inconsistent compliance with USPSTF guidelines for preventive screening within the
primary clinic is a grave evidence-based practice deficit. By developing an obvious problem
statement, formulating an aim statement concisely, and employing the PDSA cycle as an
orienting framework, this project proposes to enhance screening rates and ultimately enhance
patient outcomes. The structured process of the PDSA cycle ensures interventions are tested,
refined, and implemented in such a way as to maximize their effectiveness and sustainability.
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References
Barry, M. J., Wolff, T. A., Pbert, L., Davidson, K. W., Fan, T. M., Krist, A. H., … & Nicholson,
W. K. (2023). Putting evidence into practice: an update on the US Preventive Services
Task Force methods for developing recommendations for preventive services. The Annals
of Family Medicine, 21(2), 165-171.
Roberti, J., Jorro-Barón, F., Ini, N., Guglielmino, M., Rodríguez, A. P., Echave, C., … & Alonso,
J. P. (2025). Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process
Evaluation Using Normalization Process Theory. Pediatric Quality & Safety, 10(1), e788.
202501000-00010
