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Plan

Actual

Describe Intervention

Chosen intervention: Provide Statin Education to providers during regularly scheduled provider meeting – CDPHP to come onsite. Awaiting presentation.

Plan for intervention: CDPHP to come onsite for 1-hour educational session during provider meeting on a TBD date.

Chosen Intervention:

Date when implemented:

Updates:

Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention)

Reach of implementers/providers?

Planned: 18 providers

Reach of implementers/providers?

Actual:

Reach of patients?

Planned: N/A

Reach of patients?

Actual:

Efficacy (Impact of intervention on important outcomes)

How will you measure that your intervention is working? Pre/post-test or provider feedback

Were you able to accurately measure how your intervention was working?

What outcomes do you expect? Improved test score from pre to post-test.

What outcomes have you seen?

How will you ensure your intervention will be effective for your target population? CMO to review presentation for appropriateness.

Did your intervention reach the target population?

What unintended consequences or outcomes might there be? Provider frustration/pushback at pre/post-tests.

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. CDPHP to present at Schenectady site in conjunction with CMO/QM.

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? Meeting attendance.

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? Provider engagement with presenters/CMO.

How did you track modifications during the intervention?

What might be some of the possible obstacles to consistent implementation? Staff call outs/provider schedules.

What were the barriers to consistent intervention implementation?

What costs and resources (including time and burden, not just money) need to be considered? Provider Time: 1 hour block to provider schedules

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:

  •  Followed as designed
  •  Followed with minor modifications
  •  Followed somewhat as designed
  •  Not followed as design
  •  Delivered consistently/as intended
  •  Delivered somewhat consistently/somewhat as intended
  •  Delivered inconsistently/not as intended

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?

  •  Protocols
  •  Clinical decision support (alerts, order sets, templates, registries)
  •  Policies
  •  Regular training
  •  Regular reports
  •  Incentives
  •  Other:

Explain: If proven effective, we may offer regular trainings by CDPHP or other plans. Potentially will develop a protocol.

What reinforcements did you put into place to sustain the intervention?

  •  Protocols
  •  Clinical decision support (alerts, order sets, templates, registries)
  •  Policies
  •  Regular training
  •  Regular reports
  •  Incentives
  •  Other:

Explain:

How will you spread your intervention and lessons learned? Touchbase with providers at 1 mo month post training to get provider feedback on what’s working/what’s not, etc.

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

Chosen intervention: Patient outreach (2) weekly, utilizing Relevant report. Focus on patients with LDL > 190 who are not on statin.

Plan for intervention: Case Manager to outreach via report weekly

Chosen Intervention:

Date when implemented:

Updates:

Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention)

Reach of implementers/providers?

Planned: N/A

Reach of implementers/providers?

Actual:

Reach of patients?

Planned: 40 patients

Reach of patients?

Actual:

Efficacy (Impact of intervention on important outcomes)

How will you measure that your intervention is working? Via monthly data pull of patients with LDL greater than 190 who are on prescription.

Were you able to accurately measure how your intervention was working?

What outcomes do you expect? We would expect that number of patients who have LDL greater than 190 who are actively on prescription would increase.

What outcomes have you seen?

How will you ensure your intervention will be effective for your target population? This will tie back to reports and monthly data.

Did your intervention reach the target population?

What unintended consequences or outcomes might there be? Patient refusal to take statin, refusal to engage in care, inability to contact patient, inability to afford medication.

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. Case Managers in conjunction with the Manager of Case Management.

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? Supervision of spreadsheet by the Manager of Case Management.

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? Documentation via spreadsheet.

How did you track modifications during the intervention?

What might be some of the possible obstacles to consistent implementation? Decreased staffing in Case Management Department, competing priorities.

What were the barriers to consistent intervention implementation?

What costs and resources (including time and burden, not just money) need to be considered? Time with being short-staffed 2 Case Manager’s.

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:

  •  Followed as designed
  •  Followed with minor modifications
  •  Followed somewhat as designed
  •  Not followed as design
  •  Delivered consistently/as intended
  •  Delivered somewhat consistently/somewhat as intended
  •  Delivered inconsistently/not as intended

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?

  •  Protocols
  •  Clinical decision support (alerts, order sets, templates, registries)
  •  Policies
  •  Regular training
  •  Regular reports
  •  Incentives
  •  Other: monthly report outs to CM staff

Explain: Pulling monthly data, reporting out to CM staff on updates

What reinforcements did you put into place to sustain the intervention?

  •  Protocols
  •  Clinical decision support (alerts, order sets, templates, registries)
  •  Policies
  •  Regular training
  •  Regular reports
  •  Incentives
  •  Other:

Explain:

How will you spread your intervention and lessons learned? Discuss at Interdepartmental/Quality Meetings, Statin (Diabetics) Quality Dashboard inclusion.

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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