Abstract P255: The Effects of COSEHC Physician Process Improvement Continuing Medical Education on Patient Cardiovascular Risk Factors Outcomes in Southeastern Primary Care Clinics
| Autor: | Michael A. Moore, JaNae Joyner, Debra R. Simmons |
|---|---|
| Rok vydání: | 2011 |
| Předmět: | |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 4 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.4.suppl_2.ap255 |
| Popis: | COSEHC has developed and implemented within 20 Southeast primary care clinics a continuous process improvement (CQI) continuing medical education (PI-CME) 18 month program tailored to physicians' scope of practice to reduce physician competency gaps in achieving recommended patient cardiovascular disease (CVD) risk factor goals. Physicians were taught CQI using patient outcomes for JNC7 systolic blood pressure (SBP) and ATP III LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) goals (SBP < 140 mmHg, < 130 mmHg diabetic; LDL-C < 100 mg/dL; HDL-C> 40 mg/dL). A project faculty of CVD experts was trained to utilize slide decks in live or web based formats to improve hypertension, hyperlipidemia, and glycemic control, patient expectations, physician-patient communication, lifestyle/behavior modifications and to utilize the CQI process. At baseline, 300-400 patient charts per clinic (ICD codes 250, 272, 401) were randomly selected (7,481 total patients [54% female, 29% African American, 30% elderly [> 65 years], and 31% with diabetes]). Changes in average CVD risk factors and the percentage of patients achieving JNC-7 and ATP-III goals were determined at baseline and at three months of 18 month follow-up after the initial CME. SBP statistically decreased and HDL-C statistically increased at follow-up compared to baseline in patients having both a baseline and follow-up value. 60% (12 of 20 clinics), 55% (11 of 20 clinics), and 70% (14 of 20 clinics) improved their percentage of total patients at therapeutic target goals for SBP, LDL-C, and HDL-C respectively. The greatest improvement was among the female subpopulation where 65% (13 of 20 clinics), 50% (10 of 20 clinics), and 75% (15 of 20 clinics) improved the percentage of females at therapeutic goal for SBP, LDL-C, and HDL-C, respectively, at 3 months. It is concluded that scope of practice designed PI-CME can improve therapeutic target goal rates for CVD risk factors through a CQI process. Table 1. Changes in Cardiovascular Risk Factor Mean Values between Baseline and 3 Month Follow-up. Baseline 3 Month Follow-up Patient Record Sample Size Systolic Blood Pressure (mm Hg) 131.2 + 17.4 129.2 + 15.6 * 1958 LDL Cholesterol (mg/dL) 99.7 + 34.9 98.9 + 33.4 986 HDL Cholesterol (mg/dL) 46.7 + 15.7 48.2 + 22.4 * 1008 * p< 0.05. Values expressed as mean + standard deviation. Patients had to have both a baseline and follow-up value to be included in this paired t-test. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|