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Treatment Intensification (Combination Therapy) Plan | Treatment Intensification (Combination Therapy) Actual |
Describe Intervention (Select ONE; useBPAA Project Roadmap for ideas on evidence-based strategies) Chosen intervention: Improve patient engagement – Utilize Mercy Care Fall Festival to take patient blood blood pressures and schedule follow-ups - this is a new process for Mercy. Plan for intervention: | Chosen Intervention: CMO update HTN protocol with Primary Care Director Dr. Winzer Low dose combo therapy as the first line in the protocol Date when implemented: Updates: |
Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention) | |
Reach of implementers/providers? Planned: 670 guests attend the Fall Festival | Reach of implementers/providers? Actual: |
Reach of patients (# of patients receiving treatment intensification)? At Health Fair - 40 BP checks, 10 here elevated - education opportunity and 6 visits scheduled Planned:
| Reach of patients (# of patients receiving treatment intensification)? Actual: |
Efficacy (Impact of intervention on important outcomes) | |
How will you measure that your intervention is working? Have 6 scheduled and attended visits to Mercy Care. | Were you able to accurately measure how your intervention was working? |
What outcomes do you expect? Opportunities for education and improved BP control. | What outcomes have you seen? |
How will you ensure your intervention will be effective for your target population? Adding scheduled visits to the outcomes instead of checking BP as well. | Did your intervention reach the target population? |
What unintended consequences or outcomes might there be? Previously created protocol to address any concerns. | What unintended outcomes did you experience? |
Adoption (#/% and representativeness of staff and sites who implemented the intervention) How did clinicians respond to interventions to intensify medication more rapidly/address therapeutic inertia? | |
Who will deliver the intervention (actually do the work)? Include staff and sites, if applicable. CMA and Nursing staff will be doing BP checks, there will also be at least one provider available. | Who delivered the intervention? Did they have the skills and time needed to complete the intervention? |
How will you know if clinicians/care teams/sites used the intervention? Whether the patient returns to the office for the scheduled visit. | What proportion of the planned staff/sites implemented the intervention? Were there any differences between care teams/sites who adopted the intervention best vs. others who did not (e.g., differences in staff types, capacity, etc.)? |
Implementation Fidelity (How closely the staff/sites followed the intervention design, delivered it as intended – also called fidelity to the intervention) | |
How will you know what adaptations or modifications were made during the intervention? | How did you track modifications during the intervention? |
What might be some of the possible obstacles to consistent implementation? This was previously implemented, not expecting obstacles to implementation from the staff/site side. | What were the barriers to consistent intervention implementation? |
What costs and resources (including time and burden, not just money) need to be considered? | What costs and resources (including time and burden, not just money) need to be considered? |
How closely did the staff/sites follow the intervention design and deliver as intended? Check all that apply:
Modifications made and other notes: | |
Maintenance (Extent to which intervention is part of routine practices and protocols) | |
What reinforcements will you put in place to sustain the intervention, if effective?
Explain: | What reinforcements did you put into place to sustain the intervention?
Explain: |
How will you spread your intervention and lessons learned? | How will you spread your intervention and lessons learned? |
What are likely modifications or adaptations that will need to be made to sustain the intervention over time (e.g., lower cost, different staff, reduced intensity, different settings)? | |
Intervention #2 Plan | Intervention #2 Actual |
Describe Intervention (Select ONE; useBPAA Project Roadmap for ideas on evidence-based strategies) Chosen intervention: SMBP Program CMO Possible Intervention #3: update HTN protocol with Primary Care Director Dr. Winzer Plan for intervention: Using different forms of funding to place new orders for BP cuffs. | Chosen Intervention: Increase touchpoints – Continued follow-up with current SMBP patients who are not controlled Date when implemented: Updates: |
Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention) | |
Reach of implementers/providers? Planned: | Reach of implementers/providers? Actual: |
Reach of patients (# of patients receiving treatment intensification)? 140 Planned:
| Reach of patients (# of patients receiving treatment intensification)? Actual: |
Efficacy (Impact of intervention on important outcomes) | |
How will you measure that your intervention is working? Staff (CHW) does a 1-month f/u with patients to make sure the cuffs are being used properly and to ensure provider f/u when needed. | Were you able to accurately measure how your intervention was working? |
What outcomes do you expect? Providers will receive the BP in their inbasket if they patients are using bluetooth enabled devices. | What outcomes have you seen? |
How will you ensure your intervention will be effective for your target population? Providers use BP data to make any changes to their treatment plans. | Did your intervention reach the target population? |
What unintended consequences or outcomes might there be? Sometimes the patients don’t use the cuffs or they don’t hear back from patients. Due to the nature of their patient population, they don’t have as much access to technology. Patient compliance is the biggest issue. They use the take-back method to help educate patients and make directions clear. | What unintended outcomes did you experience? |
Adoption (#/% and representativeness of staff and sites who implemented the intervention) How did clinicians respond to interventions to intensify medication more rapidly/address therapeutic inertia? | |
Who will deliver the intervention (actually do the work)? Include staff and sites, if applicable. Pharmacists used to help with implementation/medication review but this is no longer the case. They want to reinstate the pharmacy back into the program. Patient educators and CHWs are giving the BP cuffs and education out currently to patients. | Who delivered the intervention? Did they have the skills and time needed to complete the intervention? |
How will you know if clinicians/care teams/sites used the intervention? There is a report used for MyChart bluetooth BP. There is a flowsheet for paper forms, but this is not used as frequently right now. Most paper forms are scanned in, this workflow is not fully adopted. | What proportion of the planned staff/sites implemented the intervention? Were there any differences between care teams/sites who adopted the intervention best vs. others who did not (e.g., differences in staff types, capacity, etc.)? |
Implementation Fidelity (How closely the staff/sites followed the intervention design, delivered it as intended – also called fidelity to the intervention) | |
How will you know what adaptations or modifications were made during the intervention? | How did you track modifications during the intervention? |
What might be some of the possible obstacles to consistent implementation? | What were the barriers to consistent intervention implementation? |
What costs and resources (including time and burden, not just money) need to be considered? | What costs and resources (including time and burden, not just money) need to be considered? |
How closely did the staff/sites follow the intervention design and deliver as intended? Check all that apply:
Modifications made and other notes: | |
Maintenance (Extent to which intervention is part of routine practices and protocols) | |
What reinforcements will you put in place to sustain the intervention, if effective?
Explain: This program has been going on for 3 years. | What reinforcements did you put into place to sustain the intervention?
Explain: |
How will you spread your intervention and lessons learned? | How will you spread your intervention and lessons learned? |
What are likely modifications or adaptations that will need to be made to sustain the intervention over time (e.g., lower cost, different staff, reduced intensity, different settings)? | |
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