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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: Received presentation from CDPHP on 2/5/24, sent to CMO for approval. Once approved, date will be scheduled for educational session with providers. Shared resource from NACHC: recording from NACHC on “Statin Management in High Risk Groups” by Kate Kirley. (additional note: health center is looking to implement POC cholesterol testing) The NACHC “Statin Therapy for High Risk Groups” video will be presented on March 14th at the provider meeting. |
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:
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: 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?
Explain: |
How will you spread your intervention and lessons learned? Touchbase with providers at 1 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: Set-up an excel spreadsheet on 2/2/24. Will start the week on 2/5/24 outreaching patients. Began reviewing patient charts on 2/5/2024 and will continue on a weekly basis. |
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: 7 patients as of 2/20/2024. Out of the 7, 1 patient who had an elevated LDL wants to try lifestyle modifications prior to starting a statin. |
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? 1 patient wanted to try lifestyle modifications prior to starting statin prescription. |
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? Case Managers in conjunction with the Manager of Case Management. |
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? Have a shared spreadsheet for both locations. 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.)? Amsterdam providers are performing lower overall than Schenectady providers according to the statin therapy report in Relevant database. |
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? Documentation is being maintained regarding patient outreach on spreadsheets. |
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? Time and resources continue to be a barrier to implementation. Also, delay in CLIA certificate for POC cholesterol testing is a barrier. |
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? Time and resources continue to be a barrier. |
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: Pulling monthly data, reporting out to CM staff on updates | What reinforcements did you put into place to sustain the intervention?
Explain: Discussion with CMO regarding policy/procedure on how often cholesterol screenings should be performed/follow-up visits should be scheduled after medication changes. |
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)? Will likely discuss as a topic at case manager meetings regularly. | |
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