Abstract
Evaluating the Million Hearts Learning Collaborative. Measuring and Documenting our Impact Together
Karl Ensign, MPP, Association of State and Territorial Health Officials, Arlington, VA and Rebecca Brady, Association of State and Territorial Public Health Officials (ASTHO), Arlington, VA
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
The Million Hearts initiative enhances cardiovascular disease prevention activities across the public and private sectors in an unprecedented effort to prevent 1 million heart attacks and strokes by 2017. The Association of State and Territorial Health Officials’ (ASTHO) Million Hearts Learning Collaborative assists state health agencies efforts to achieve these goals.
Sixteen state health agencies and one freely associated state territory were selected to participate in the Million Hearts Learning Collaborative. States are utilizing a quality improvement process to partner across sectors to implement evidence-based strategies to identify, control, and improve blood pressure. The teams are using the Plan, Do, Study, Act (PDSA) model to test and spread systems-level changes using the following levers: data analysis and sharing, creating community clinical linkages, and financing/reimbursement policy.
Participatory evaluation strategies were used to track the change process and measure impact. Through an iterative process, an overarching logic model was developed with participating states, the project team and the funding agency. Within this framework, states self-identified the portions of the logic model that reflected their specific interventions and intended outcomes. Collaborative efforts were undertaken to standardize measurement and data reporting. A data entry tool was developed and placed on a shared website. This facilitated shared ownership of the evaluation as states could see both individual and collective impact. Capacity building assistance was provided with an emphasis on facilitating peer-to-peer TA. The logic model was used as a framework for discussion and analysis within the team and across participating sites.
There are early indications of success. All states adopted the National Quality Forum 18 (NQF-18) blood pressure control performance measure. Participating states report affecting 90,000 patients and potentially reaching 1.5 million. In just 9 months, several clinics demonstrated improvement in the percentage of hypertensive patients under control by as much as 12 percentage points.
Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Planning of health education strategies, interventions, and programs Public health administration or related administration
Abstract
Million Hearts Implementation: A 16 State Learning Collaborative to Improve Hypertension Control
Elizabeth Walker Romero, MS1, Letitia R. Presley-Cantrell, PhD2, Lynn Shaull, MA3, Katie Potestio, MPH, RD3, Michael Sells, MSPH2 and Robin Diggs Outlaw, MPH4
(1)ASTHO, Arlington., VA, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Association of State and Territorial Health Officials, Arlington, VA, (4)DC Department of Health, Washington, DC, DC
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
In the United States, one in three Americans have high blood pressure leading to increased risk for stroke and heart attacks and costs the country 47.5 billion each year. In an effort to reduce one million incidents of stokes or heart attacks by 2017, Million Hearts was launched by the federal government to address aspirin, blood pressure, cholesterol and smoking cessation. ASTHO, with support from the Centers for Disease Control and Prevention, selected sixteen state health agencies (ten the first year and six the second year) to participate in a Million Hearts state learning collaborative. The states are utilizing a quality improvement process to partner across sectors to implement evidence-based strategies to identify, control, and improve blood pressure. Each state team, led by the state health agency, is made up of local public health agencies, healthcare partners, quality improvement organizations, HIT expertise, and public and private payers. ASTHO utilizes a systems-level change approach which leverages data, financing, policy, and protocols, standardizing practice, and community-clinical linkages. States in the collaborative have made progress in each of the areas. States have partnered with payors to explore pay for performance to control hypertension, performance measure alignment, and financing community health workers. States have utilized data to drive change at multiple levels of the system. For example, at the population level, one state analyzed discharge data to create GIS maps to target community efforts to more local level data use such as using EHR data for panel management. Working with clinical partners, protocols were implemented by practices. These protocols included referral systems to local public health to ensure follow up and continued treatment. Utlizing a systems approach with the learning collaborative, ASTHO has supported the states leading to improved hypertension control and spread of best practices and policies.
Administer health education strategies, interventions and programs Administration, management, leadership Chronic disease management and prevention Clinical medicine applied in public health Communication and informatics Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Million Hearts Implementation: A 16 State Learning Collaborative to Improve Hypertension Control Across Sectors
Elizabeth Walker Romero, MS1, Letitia Presley-Cantrell, PhD2, Karl Ensign, MPP3, Michael Sells, MSPH2, Lisa F Waddell, MD, MPH4 and Katie Potestio, MPH, RD3
(1)ASTHO, Arlington., VA, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Association of State and Territorial Health Officials, Arlington, VA, (4)ASTHO, Arlington, VA
2015 APHA Annual Meeting & Expo (Oct. 31 - Nov. 4, 2015)
ASTHO, with support from the Centers for Disease Control and Prevention, selected sixteen state health agencies (ten the first year and six the second year) to participate in a Million Hearts state learning collaborative. The states are utilizing a quality improvement process to partner across sectors to implement evidence-based strategies to identify, control, and improve blood pressure. This session will focus on CDC recommended hypertension best practice and evidence with an overview of the successes of the Million Hearts Learning Collaborative. New York and Washington DC will present on their key findings from their Million Health learning collabortive iniatiive highlighting the role of system change and spread and sustainabililty of their efforts.
Administration, management, leadership Chronic disease management and prevention Communication and informatics Other professions or practice related to public health Public health administration or related administration Systems thinking models (conceptual and theoretical models), applications related to public health