Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Diana Beckmann-Mendez


Esmeralda Gill


The purpose of this quality improvement project was to increase adult annual wellness visits in a high-volume family practice clinic. The significance of an adult annual wellness exam is health maintenance, disease prevention, early disease detection, and management of chronic diseases. Approximately 133 million Americans are diagnosed with at least 1 chronic disease, including cancer, diabetes, and heart disease, and 1 in 4 adults are diagnosed with multiple chronic diseases (Raghupathi & Raghupathi, 2018). In 2011, the Affordable Care Act mandated insurance companies to remove deductibles for preventative health services, relieving the financial burden of out-of-pocket expenses (Borsky et al., 2018). Despite this financial relief, only 8% of adults 35 years of age and older reported receiving all of the recommended preventative health care services as of 2015 (Borsky et al., 2018). Recommended medical screenings and risk assessments are based on the U.S. Preventive Services Task Force derived from evidence-based practice. The screenings are dependent on sex, age, tobacco use, and sexual history (Owolabi & Simpson, 2012; Viera, 2018). The aim of this study was to increase the number of completed adult annual wellness visits. Interventions included staff education, implementation of a provider prompt slip to include “schedule adult annual wellness visit,” and sending electronic reminders and recalls for patients to schedule an annual wellness visit. These interventions resulted in a 28% increase in completed adult annual wellness visits. To maintain sustainability, it is crucial to have provider buy-in. Patients also expected that their provider recommend the need to complete an annual wellness visit.