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Plan | Actual |
Describe Intervention Chosen intervention: YouTube video – getting on iPads or terminals in each exam room for videos only or getting link to patients to watch on smartphones (Spanish and English versions) PHAS Year 4 Statin Tool Testing.docx Plan for intervention: : using the same YouTube video will expand to SpSp version. We will initiate beyond pilot team at Davis site (DCC) to all DCC teams starting Dec 2023 and then all provider teams at the other original CCHC sites by Mar 2024. | Chosen Intervention: Date when implemented: Updates: added Spanish video |
Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention) | |
Reach of implementers/providers? Planned: All Providers, all sites | Reach of implementers/providers? Actual: have tested with one provider panel as of 2/5, plan to expand to two others |
Reach of patients? Planned: one site 8 to 10 pts a day to start with | Reach of patients? Actual: will add numbers after call |
Efficacy (Impact of intervention on important outcomes) | |
How will you measure that your intervention is working? ? --Survey for patients – tool influence understanding their risk and willingness to initiate or continue statin RX? --Did prescribing increase for patients who received the tool? don't know if patient will take Rx or not, conversation around lifestyle and MI style - statin is an option but not always selected by pt, at next visit present numbers again - this has changed because of goals - statin might happen 3rd visit , option for clinician tallying impact of conversation and MA measuring number of patients exposed to the video Q: tailored strategy for high risk patients (don’t need high risk calculator for them) - A: challenge for patients not on a statin yet is lack of opportunity to provide patient choice if can capture number of conversations it takes for patients to uptake statins would be very helpful information | Were you able to accurately measure how your intervention was working? 2/5 In December encountered some barriers - wanted an ipad with every panel to show videos in English and Spanish along with risk calculator - still waiting for ipads, should have them by next month. |
What outcomes do you expect? Increase patient education and engagement. Patients that watch the video will decide to get on a statin. influence understanding their risk and willingness to initiate or continue statin RX | What outcomes have you seen? Pilot provider reported it was helpful to have app and show the patients and convince them to try the Rx or be compliant. There was some tracking by medical assistants that might be helpful data. Spreading to other provider with less well established panels or different routine/ way they get through patient visits will be interesting to see if the effectiveness holds. |
How will you ensure your intervention will be effective for your target population? | Did your intervention reach the target population? 2/5 discussed social needs questions - need for care management but not sure if there is capacity for that |
What unintended consequences or outcomes might there be? | 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. Medical Assistant/ Provider | Who delivered the intervention? Did they have the skills and time needed to complete the intervention? 2/5 time is a factor - figuring out what to offload from provider or other care team help out |
How will you know if clinicians/care teams/sites used the intervention? provider two-question survey | 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.)? see notes above - in process. Questions were around whether using ASCVD risk tool was working, if it is helpful in reviewing with patients (simple 2 measure survey). Health Efficient offered to share their questions |
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? Capacity, health center merger | What were the barriers to consistent intervention implementation? |
What costs and resources (including time and burden, not just money) need to be considered? EHR transition April 2024 Go live but prep will start several months before. Staff Capacity. | 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? Internal health center meetings. Aliados Health peer network meetings. | 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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