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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. |
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Plan | Actual |
Describe Intervention Chosen intervention: Provider Professional Development Plan for intervention:
| Chosen Intervention: Provider Professional Development Date when implemented: Updates:
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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: #of PCPs? |
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?
| Were you able to accurately measure how your intervention was working?
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What outcomes do you expect?
| What outcomes have you seen?
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How will you ensure your intervention will be effective for your target population?
| Did your intervention reach the target population?
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What unintended consequences or outcomes might there be? | What unintended outcomes did you experience?
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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); Yes |
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:
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? | 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)? | |
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