Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

Health Professions

First Advisor

Dr. Della Hughes-Carter, DNP, RN, BC-GNP

Second Advisor

Dr. Rebecca Davis, PhD, RN

Academic Year



Background: Medicare Annual Wellness Visits (AWVs) promote preventive services. Completion rates remain low among rural, underserved populations. A Midwest Rural Health Clinic (RHC) was not achieving its AWV completion goal due to inconsistent processes and scheduling challenges.

Objectives: To establish a workflow to increase AWV completion rates, thereby increasing depression screening and improving time efficiency using a team approach.

Methods: The quality improvement project was implemented using the Plan-Do-Study-Act framework at an RHC serving 942 Medicare beneficiaries. Participants included clinical staff and 170 beneficiaries. A workflow was developed to engage multidisciplinary team members in promoting, scheduling, and completing AWVs. A cost-benefit analysis was completed to examine the impact of redeploying existing staff to participate in AWV completion. The project measures included: the total number of Medicare AWVs completed and the impact of a team approach on the time required by the PA for visit completion.

Results: An independent samples t-test and Mann-Whitney U test were run using SPSS version 27 to determine the difference in AWV completion rates and pre and post-intervention visit duration. There was an increase in the number of AWVs completed (n=170), significant cost savings and increased revenue, and a statistically significant reduction in time required by the PA for AWV completion (pre-intervention: median=70.5; post-intervention: median=28.5; n=34, U=12.00, Z=-5.059, p-value=<.001).

Conclusion: Utilizing a multidisciplinary approach increased AWV completion rates, thereby improving depression screening, improving time efficiency, and generating increased revenue for the RHC

Available for download on Monday, April 28, 2025