Add the ground turkey to a soup pot/Dutch oven and break it up a little bit with your spoon. Let it cook, without stirring, over medium-high heat for 5-6 minutes.
Add the onion to the pot and stir/break the meat up into small pieces. Let it cook for another 5 minutes or so.
Stir in the garlic, red pepper flakes, Italian seasoning, and orzo. Cook for about a minute.
Stir in the tomato sauce, beef broth, cream, and Worcestershire sauce. Once it starts to bubble, continue cooking for 10 minutes, uncovered, stirring fairly often (so the orzo doesn't stick to the bottom of the pot). You will likely need to turn the heat down a bit (to medium or even medium-low). It should gently bubble vs. boil (you don't want the liquid to reduce too much before the pasta has cooked).
Take the pot off the heat, stir in the parmesan and spinach, and cover the pot for about 3-5 minutes or until it has thickened up to your liking. Season with salt & pepper as needed and serve immediately.
Enjoy!
