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Plan | Actual |
Describe Intervention Chosen intervention: Clinical Pharmacist and students will chart review patients with DM, who are non-compliant for statin metric & review statin intensity.. Director of Performance Improvement, will perform chart audits on patients with LDL > 190 Plan for intervention: List will be provided to this team to outreach, focusing on LDL >190. | Chosen Intervention: Date when implemented: October 2023 (DM), November 2023 (LDL >190) Updates: clinical pharmacist and students did outreach |
Reach (#/% patients – or providers, for provider-facing interventions – who participated in intervention) | |
Reach of implementers/providers? Planned: 3 (1 Clinical Pharmacist + 2 students) | Reach of implementers/providers? Actual: |
Reach of patients? Planned: 80 | Reach of patients? Actual: Over the months of September/October:
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Efficacy (Impact of intervention on important outcomes) | |
How will you measure that your intervention is working? # patients of our planned reach that we actually reached. Of those, # patients switched to the compliant category. | Were you able to accurately measure how your intervention was working?
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What outcomes do you expect? We expect to identify patients who have refused statins in the past and will likely always remain “non-compliant”, but we will find more patients who are eligible for statins and we will be able to intervene. | What outcomes have you seen?
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How will you ensure your intervention will be effective for your target population? Measure outcome of # patients moved to compliant category and ideally, track therapeutic goals. | Did your intervention reach the target population?
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What unintended consequences or outcomes might there be? Expert Consensus still not published as guidelines yet, so it remains unclear which direction we should counsel providers in. | 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. Clinical Pharmacist and students followed by Providers implementing the decisions of statin Rx. | Who delivered the intervention? Did they have the skills and time needed to complete the intervention?
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How will you know if clinicians/care teams/sites used the intervention? Tracking lists of patients | 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.)?
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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? Patient list/tracking | How did you track modifications during the intervention?
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What might be some of the possible obstacles to consistent implementation? Frequent chart review and education to providers | What were the barriers to consistent intervention implementation?
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What costs and resources (including time and burden, not just money) need to be considered? Time is the biggest one. Time to chart review, send messages with recommendations to providers, time to outreach to patients, etc. | What costs and resources (including time and burden, not just money) need to be considered?
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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: December 2023 clinical pharmacist conducted a training with providers on LDL> 190 and statin use. |
How will you spread your intervention and lessons learned? Review of the chart reviewed data overall with teams | How will you spread your intervention and lessons learned?
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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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