Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma
Abstract Background Cardiovascular disease (CVD) is the leading cause of death in the US and incurs high health care costs. While many initiatives promote the implementation of ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) measures, most primary care p...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3189-4 |
| _version_ | 1819267789402144768 |
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| author | Ann F. Chou Juell B. Homco Zsolt Nagykaldi James W. Mold F. Daniel Duffy Steven Crawford Julie A. Stoner |
| author_facet | Ann F. Chou Juell B. Homco Zsolt Nagykaldi James W. Mold F. Daniel Duffy Steven Crawford Julie A. Stoner |
| author_sort | Ann F. Chou |
| collection | DOAJ |
| description | Abstract Background Cardiovascular disease (CVD) is the leading cause of death in the US and incurs high health care costs. While many initiatives promote the implementation of ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) measures, most primary care practices (PCPs) lack quality improvement (QI) support and resources to achieve meaningful targets. The Healthy Hearts for Oklahoma (H2O) Study proposes to build a QI infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; (2) providing QI support in PCPs to better manage patients at risk for CVD events. Parallel to infrastructure building, H2O aims to conduct a comprehensive evaluation of the QI support D&I in primary care and assess the relationship between QI support uptake and changes in ABCS measures. Methods H2O has partnered with public health agencies and communities to build OPHIC and facilitate QI. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS performance. A stepped-wedge designed is used to evaluate D&I of QI support. Changes in ABCS measures will be estimated as a function of various components of the QI support and capacity and readiness of PCPs to change. Notes from academic detailing and practice facilitation sessions will be analyzed to help interpret findings on ABCS performance. Discussion H2O program is designed to improve cardiovascular health and outcomes for more than 1.25 million Oklahomans. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations. Lessons learned from this project will guide future strategies for D&I of evidence-based practices in PCPs. Trained practice facilitators will continue to serve as critical resource to assists small, rural PCPs in adapting to the ever-changing health environment and continue to deliver quality care to their communities. |
| first_indexed | 2024-12-23T21:22:45Z |
| format | Article |
| id | doaj.art-82e6495ccdfa4225a5dc39030e045c80 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-23T21:22:45Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-82e6495ccdfa4225a5dc39030e045c802022-12-21T17:30:42ZengBMCBMC Health Services Research1472-69632018-06-0118111310.1186/s12913-018-3189-4Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for OklahomaAnn F. Chou0Juell B. Homco1Zsolt Nagykaldi2James W. Mold3F. Daniel Duffy4Steven Crawford5Julie A. Stoner6College of Medicine, Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences CenterSchool of Community Medicine, The University of Oklahoma Health Sciences CenterCollege of Medicine, Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences CenterCollege of Medicine, Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences CenterSchool of Community Medicine, The University of Oklahoma Health Sciences CenterCollege of Medicine, Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences CenterCollege of Public Health, The University of Oklahoma Health Sciences CenterAbstract Background Cardiovascular disease (CVD) is the leading cause of death in the US and incurs high health care costs. While many initiatives promote the implementation of ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) measures, most primary care practices (PCPs) lack quality improvement (QI) support and resources to achieve meaningful targets. The Healthy Hearts for Oklahoma (H2O) Study proposes to build a QI infrastructure by (1) constructing a sustainable Oklahoma Primary Healthcare Improvement Collaborative (OPHIC) to support dissemination and implementation (D&I) of QI methods; (2) providing QI support in PCPs to better manage patients at risk for CVD events. Parallel to infrastructure building, H2O aims to conduct a comprehensive evaluation of the QI support D&I in primary care and assess the relationship between QI support uptake and changes in ABCS measures. Methods H2O has partnered with public health agencies and communities to build OPHIC and facilitate QI. H2O has 263 small primary care practices across Oklahoma that receive the bundled QI intervention to improve ABCS performance. A stepped-wedge designed is used to evaluate D&I of QI support. Changes in ABCS measures will be estimated as a function of various components of the QI support and capacity and readiness of PCPs to change. Notes from academic detailing and practice facilitation sessions will be analyzed to help interpret findings on ABCS performance. Discussion H2O program is designed to improve cardiovascular health and outcomes for more than 1.25 million Oklahomans. The infrastructure established as a result of this funding will help reach medically underserved Oklahomans, particularly among rural and tribal populations. Lessons learned from this project will guide future strategies for D&I of evidence-based practices in PCPs. Trained practice facilitators will continue to serve as critical resource to assists small, rural PCPs in adapting to the ever-changing health environment and continue to deliver quality care to their communities.http://link.springer.com/article/10.1186/s12913-018-3189-4Primary careQuality improvementPractice facilitationCardiovascular diseasePatient-centered outcomesImplementation and dissemination |
| spellingShingle | Ann F. Chou Juell B. Homco Zsolt Nagykaldi James W. Mold F. Daniel Duffy Steven Crawford Julie A. Stoner Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma BMC Health Services Research Primary care Quality improvement Practice facilitation Cardiovascular disease Patient-centered outcomes Implementation and dissemination |
| title | Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma |
| title_full | Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma |
| title_fullStr | Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma |
| title_full_unstemmed | Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma |
| title_short | Disseminating, implementing, and evaluating patient-centered outcomes to improve cardiovascular care using a stepped-wedge design: healthy hearts for Oklahoma |
| title_sort | disseminating implementing and evaluating patient centered outcomes to improve cardiovascular care using a stepped wedge design healthy hearts for oklahoma |
| topic | Primary care Quality improvement Practice facilitation Cardiovascular disease Patient-centered outcomes Implementation and dissemination |
| url | http://link.springer.com/article/10.1186/s12913-018-3189-4 |
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