Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.
Panel
panelIconIdatlassian-info
panelIcon:info:
panelIconText:info:
bgColor#DEEBFF

Instructions: Use the pencil icon in the top right to edit the form below. ↗️ Remember to push PUBLISH when you are done to save your work.

...

Plan

Actual

Describe Intervention

Chosen intervention: Provider Professional Development

Plan for intervention:

  • CMO 1:1 which includes chart reviews (peer reviews), UDS cheat sheet, alignment with evidence based guidelines

    • Ongoing provider education on cholesterol guidelines & strategies to overcome patient hesitancy (motivational interviewing), fine tuning the way we share information and improvement efforts with providers (newsletter).

  • Provider meetings: Portia provides QI overview

    • Each meeting a topic is selected - an issue is the amount of time to explore any topic - each month run providers list of patients who should be on statin therapy and sort by outcome (those not on statin and should be are at top of list.

    • heart health champion motivates performance

Chosen Intervention:

Date when implemented:

Updates:

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

Reach of implementers/providers?

Planned: 100% of PCPs will receive education on cholesterol guidelines & strategies to overcome patient hesitancy

Reach of implementers/providers?

Actual:

Reach of patients? : 50% of patients at high risk for a cardiovascular event will receive education using a validated clinical reference tool.

Reach of patients?

Actual:

Efficacy (Impact of intervention on important outcomes)

How will you measure that your intervention is working?

  • Epic UDS data for statin therapy

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

What outcomes do you expect?

  • 82% of patients at high risk for a cardiovascular event will be prescribed a statin.

What outcomes have you seen?

How will you ensure your intervention will be effective for your target population?

  • Monthly data analysis

Did your intervention reach the target population?

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.

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?

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:

  •  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:

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?

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: PCN Previsit Planning

Plan for intervention:

Lists generated. Providers review list and f/u with patients.) Might add staff to add with measures - now that can look at care gaps and quality measures - that extra person could help the providers. In UDS system - BCOM small and Portia is in UDS.) Some inertia. Still recognize the provider heart health champion - this is motivating providers to look at all heart health measures - riding on interest that created this summer)

Wave in Epic - also happening at network level

could do a in person or virtual visit
  • PCN provides information to providers in advance of provider-led huddle

  • Working on attaining pop health nurse. In meantime, QI nurse (Natasha) to commit 1 day/week to work on pop health activities, pending approval.

    • Managed care team will support Natasha in pt outreach in advance of appt to managed care pts

    • PCNs outreach to other pts (divide & conquer)

Chosen Intervention:

Date when implemented:

Updates:

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

Reach of implementers/providers?

  • Planned: 2 PCNs

Reach of implementers/providers?

Actual:

Reach of patients?

  • All BCOM patients

Reach of patients?

Actual:

Efficacy (Impact of intervention on important outcomes)

How will you measure that your intervention is working?

  • More ASCVD & Hyperchol / LDL patients receiving statin rx.

  • improvement in cholesterol screening and UDS report outcomes

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

What outcomes do you expect?

Increase in Statin Rx & cholesterol screening measures

What outcomes have you seen?

How will you ensure your intervention will be effective for your target population?

Cohort f/u and rx performance increase

Did your intervention reach the target population?

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.

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?

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:

  •  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:

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?

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)?

...