A M.A.P. for Improving Health Outcomes: Achieving Optimal Hypertension Control Donna Daniel, PhD¹, Lisa Lubomski, PhD², Lisa Cooper, MD, MPH², Matthew Wynia, MD, MPH¹, Romsai Tony Boonyasai, MD, MPH², Kathryn Taylor, RN, MPH², Marsha Kaufman, MSW¹, Shahid Choudhry, PhD¹, Mavis Prall, MSJ, MS¹ ¹American Medical Association and ²Johns Hopkins Medicine AMA Strategic Focus Adapting TRiP/CUSP to Ambulatory Setting Identified Three Focus Areas for Improvement The American Medical Association is committing its resources, expertise and reach to prevent heart disease and type 2 diabetes and to improve outcomes for those suffering from these diseases. The toll of these two diseases—both in dollars and human suffering—is staggering. We describe our heart disease work here. Cardiovascular Disease Cardiovascular disease causes one-third of all deaths in the United States. Translating Research/Evidence into Practice (TRiP) Measure accurately Without credible BP measurements, clinicians cannot make wise therapeutic decisions Act rapidly Therapeutic inertia is often the primary reason for uncontrolled hypertension when BP control rates are low Partner with patients to promote self-management Evidence-based ways for supporting patients’ ability to adhere to and self-manage their care are underutilized AMA Approach In developing our strategic focus the AMA spoke with many stakeholders, recognizing that many have been addressing cardiovascular disease. We then embarked on this innovation pathway: Reassess & adjust Devise interventions The M.A.P. to achieve optimal hypertension control  Evidence-based  Relevant to clinicians  Generalizable to many settings  Anyone can understand Scale for impact Comprehensive Unitbased Safety Program (CUSP) 1. Summarize the evidence in a behavioral checklist 1. Educate staff on science of quality improvement 2. Identify local barriers to implementation 2. Identify defects 3. Measure performance 4. Ensure all patients get the intervention • Engage • Educate • Execute • Evaluate M. A. P. 3. Assign clinical & administrative team leaders 4. Learn from one defect per quarter 5. Implement teamwork tools Prototyping Underway Hypertension control rates above 90% Implement & test Research & evaluate Improving Health Outcomes: BP The AMA is collaborating with the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities. We call this joint initiative “Improving Health Outcomes: Blood Pressure” or “IHO: BP.” Data Collection and Evaluation Clinical Performance Our collaborators at Johns Hopkins have proven track records when it comes to creating and spreading clinical improvement strategies. We are focused on the 30 million Americans who have a usual source of care, yet their hypertension remains uncontrolled. We are creating novel tools and promoting resources from existing programs such as the Million Hearts® initiative, AMGA’s Measure Up/Pressure Down®, and American Heart Association/American Stroke Association. RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com i.e. checklists QI Technical Work Sweet (TRiP) Spot Adaptive Work (CUSP) Areas for Improvement: Measure, Act, Partner i.e. culture PCA GPS Contact Donna Daniel, PhD [email protected] 312-464-4607 www.ama-assn.org/go/hypertension