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Important Health Center Context

Fill out this section during your planning process

Internal Characteristics

What are the characteristics of your health center? (rural/urban; other demographic variables) ?  

  • Urban

  • Patient Population Mix:

    • Adults: 55.35%

    • Racial and/or Ethnic Minority: 96.98%

    • Black/African American: 84%

What are infrastructure characteristics of your health center (use of expanded care team, culture)?

How do interventions and/or workflows need to be adapted to ensure health equity?

How complex are the patient interventions to implement (e.g., perceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, and number of steps required)?

What are key characteristics of the participating setting(s)?

External Characteristics

What external or environmental supports or threats are there?

Treatment Intensification (Combination Therapy)

Plan

Treatment Intensification (Combination Therapy)

Actual

Describe Intervention

(Select ONE; use BPAA Project Roadmap for ideas on evidence-based strategies)

Chosen intervention: registry lists of patients with uncontrolled htn on no or monotherapy and determine what intervention would be (e.g., script for patient to intensify medication, use Simplify your Pill Routine cards, other intervention that will focus on intensifying medication)

Plan for intervention: have been validating and analyzing patient level data (ensure provider has seen patient, uncontrolled patients on no or monotherapy), put into dashboard to examine trends, choose a provider to pilot, may share at provider meeting with visual

Chosen Intervention: Focus on patients on no or monotherapy

Date when implemented: January 1, 2024

Updates:

Reviewed the plan with health center leads. Currently working through patient list on no therapy to identify cohort of patients to focus.

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

Reach of implementers/providers?

Planned: 15-20 providers

Reach of implementers/providers?

Actual:

Reach of patients (# of patients receiving treatment intensification)?

Planned:

  • # AA pts. w/uncontrolled HTN on no therapy (as of 6/30/2023): 371

  • # AA pts. w/uncontrolled HTN on monotherapy (as of 6/30/2023): 851

Reach of patients (# of patients receiving treatment intensification)?

Actual:

Efficacy (Impact of intervention on important outcomes)

How will you measure that your intervention is working?

looking at data on this group of patients to see if they had their medication intensified (can chart audit)

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

What outcomes do you expect?

look at number of appointments coming in for the month and determine a reasonable goal based on n, will do chart audits after the appointment to determine the result, also want to see if accidentally prescribing monotherapy. Goals will be increased as have success

What outcomes have you seen?

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

that patient does have the recommended medication prescribed

Did your intervention reach the target population?

What unintended consequences or outcomes might there be?

might have prescription, but will adherence be an issue, and won’t be able to look at this until subsequent visit

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

(Select ONE; use BPAA Project Roadmap for ideas on evidence-based strategies)

Chosen intervention:

Plan for intervention:

Chosen Intervention:

Date when implemented:

Updates:

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

Reach of implementers/providers?

Planned:

Reach of implementers/providers?

Actual:

Reach of patients (# of patients receiving treatment intensification)?

Planned:

  • # AA pts. w/uncontrolled HTN on no therapy (as of 6/30/2023):

  • # AA pts. w/uncontrolled HTN on monotherapy (as of 6/30/2023):

Reach of patients (# of patients receiving treatment intensification)?

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?

What outcomes do you expect?

What outcomes have you seen?

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

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)?



Version Date Comment
Current Version (v. 6) Jan 05, 2024 16:41 Lauren Becker
v. 11 May 09, 2024 19:02 Varun Venkateswaran
v. 10 Apr 30, 2024 17:06 Varun Venkateswaran
v. 9 Mar 18, 2024 19:15 Varun Venkateswaran
v. 8 Feb 21, 2024 19:47 Meg Meador
v. 7 Feb 20, 2024 20:34 Varun Venkateswaran
v. 6 Jan 05, 2024 16:41 Lauren Becker
v. 5 Dec 20, 2023 18:36 Varun Venkateswaran
v. 4 Nov 16, 2023 17:37 Varun Venkateswaran
v. 3 Nov 13, 2023 16:38 Varun Venkateswaran
v. 2 Nov 13, 2023 16:36 Varun Venkateswaran
v. 1 Sept 18, 2023 18:04 Lauren Becker
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