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: Provider Professional Development

  • CMO 1:1

    • Implemented: January 2023

    • Frequency: met with everyone initially, now offered as needed

    • Purpose: provider productivity, professional development, following evidence-based guidelines

  • Provider meeting

    • Implemented: Today’s structure implemented Spring 2023

    • Frequency: Monthly

    • Purpose: show and tell, announcements/updates, productivity, UDS, clinical trends, special programs, finance, presentations from vendors/partners

  • All staff meeting:

    • Implemented: a long time ago

    • Frequency: Quarterly

    • Purpose: Providers and staff hear updates together (Quality Improvement is led by Portia & Dr. Chery)

  • Biweekly Breakfast Club:

    • Implemented: July 13, 2023 (after MH Harvest meeting (smile) )

    • Frequency: 2x/month

    • Purpose: specific clinical topic each month

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: 11 PCPs (100%)

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: AA to make report. Statin UDS denominator, who received a MH clinical reference for statin therapy.

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?

  • Yes

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?

  • 84% rolling 12 months as of April 2024

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

  • Monthly data analysis

Did your intervention reach the target population?

  • Yes

What unintended consequences or outcomes might there be?

What unintended outcomes did you experience?

  • Increase in aspirin for IVD?all heart health CHQR Badge measures because we view them all together

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?

Dr. Stevenson Chery (CMO) ; Yeslead the forums for all PCPs. Yes, has the skills and time to complete.

The providers attended, engaged, and implemented what they learned. Yes, has the skills and time to complete.

How will you know if clinicians/care teams/sites used the intervention?

Run reports on clinical reference use and as well as net change in statin uds performance.

What proportion of the planned staff/sites implemented the intervention?

100%

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.)?

N/A

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?

Awarding sites for all other CQ measures to encourage understanding of measures and drive performance.

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)?

...