Learning Objective #1: Identify the US Preventive Services Taskforce (USPSTF) guidelines and relevant tools that will improve delivery of clinical preventive services

Learning Objective #2: Identify the USPSTF recommendations that were identified as priority for implementation by health plan medical directors

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Purpose: Delivery rates of specific Clinical Preventive Services (CPS) in NJ's Health Plans (HP) are below state and national goals. An inconsistent approach to the delivery of CPS could prove to be a barrier to implementation of these services. Clinicians contract with varying HPs and are confronted with many sets of conflicting guidelines for preventive care. Therefore, the project purpose was to improve delivery of CPS through use of a consistent set of CPS guidelines by contracted health plan clinicians across NJ. Methods: Sample consisted of nine Medical Directors of the largest HPs in NJ; HPs that cover 2,293,491 of the 2,358,474 NJ residents enrolled in HMOs. Delphi Method was used to reach consensus on CPS guidelines. First survey collected baseline information on each HP's level of agreement/disagreement with CPS guidelines. A scientific expert discussed these guidelines and a second survey, providing group's ratings to the listed CPS guidelines, was given. Delphi Rounds addressing priority level of each positive recommendation was then facilitated. Results: First Delphi Round demonstrated 14 areas of disagreement; seven areas of disagreement in second Delphi Round. Consensus on these areas of disagreement was then reached. Recommendations HP Medical Directors agreed on were then rank ordered to identify priority for implementation. Conclusions: Conflicting and confusing guidelines are detrimental to delivery of preventive care, creating a major system barrier against improvement of these services. A systematic approach was used to reach consensus among HP Medical Directors on CPS guidelines and implementation tools. This approach provides clinicians, including nurses, with organizational support to access and synthesize the best evidence to deliver preventive services in practice. Additionally, it provides a template for HPs nationwide to reach consensus on guidelines and implementation tools supporting clinicians, including nurses, in the consistent delivery of CPS.