Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Joan Kearney

Abstract

Clinical Data Integration: Impact on Quality Outcomes

Hospital readmissions continue to contribute substantially to poor patient outcomes and rising healthcare expenditures in the United States, with nearly 20% of Medicare beneficiaries readmitted within 30 days. Fragmented health information systems also impede care coordination and restrict providers’ capacity to deliver timely, high-quality care. This Doctor of Nursing Practice (DNP) project developed, implemented, and evaluated a provider dashboard that integrates real-time clinical and operational data to support primary care providers within a large multistate independent provider association.Guided by the Lean Six Sigma DMAIC framework, this quality improvement project was conducted with 10 primary care providers over a three-month period. The intervention included implementing a provider portal that integrates hospital admissions, utilization data, HEDIS quality measures, and annual wellness exam (AWE) completion rates. Training was provided to internal staff and providers. Outcomes were evaluated using pre- and post-knowledge tests, program evaluations, and clinical metrics, with analyses including paired t-tests, chi-square tests, and mixed-effects modeling. The results indicated a statistically significant improvement in provider knowledge, with a mean increase of 2.1 points (p = 0.001). AWE completion rates increased by 6.9% (95% CI: 1.3%–12.4%, p = 0.032). Hospital readmission rates did not show a statistically significant change, which may be attributable to the short evaluation period and seasonal variation. The implementation of integrated provider dashboards is intended to enhance quality outcomes and inform clinical decision-making. Ongoing expansion and longitudinal evaluation are advised to determine effects on readmission rates and long-term sustainability.

Comments

This is an Open Access Thesis.

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