Improving cardiovascular outcomes by using team-supported, EHR-leveraged, active management: Disseminating a successful quality improvement project.
Improving cardiovascular outcomes by using team-supported, EHR-leveraged, active management: Disseminating a successful quality improvement project.
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通过团队支持、ehr杠杆化、主动管理来改善心血管结果：传播一个成功的质量改进项目。
DOI：
10.1016/j.conctc.2021.100705
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发表时间：
2021-03
影响因子：
1.5
通讯作者：
Zullig LL
中科院分区：
文献类型：
--
作者：
Lewinski AA;Bosworth HB;Goldstein KM;Gierisch JM;Jazowski S;McCant F;White-Clark C;Smith VA;Zullig LL
血压不受控制在退伍军人中很常见。农村退伍军人面临着护理协调不理想的风险，因为由于个人和系统层面的因素，成功的计划可能会以较低的速度实施。有强有力的证据支持使用远程提供的支持以及来自家庭血压监测仪和虚拟血压就诊的患者生成的数据来管理血压。该项目的目的是增强当前解决血压失控问题的方法，以便现有的临床工作人员能够接触到更多的患者群体。我们的项目将通过利用基于团队的护理、退伍军人健康管理局电子健康记录和以患者为中心的医疗家庭数据来解决失控的血压问题，以解决患者、提供者和系统在心血管疾病 (CVD) 预防护理方面的障碍。我们将在三个农村退伍军人健康管理局诊所的心血管疾病实践中实施该项目。我们将在单臂、前后设计中评估实施流程以及患者层面（例如，临床结果、转诊至专业服务）结果。本手稿描述了我们扩大实施一个成功项目的过程，该项目旨在改善高风险农村退伍军人的血压控制。我们的研究结果将有助于了解农村社区诊所潜在可扩展的血压干预措施的实施和临床效果。对血压不受控制的退伍军人进行适当的管理可以降低与心血管疾病相关的发病率和死亡率。反过来，血压的改善可以提高质量指标，并可能降低医疗保健系统的成本。血压不受控制在农村退伍军人中很常见，因为在农村环境中获得护理可能具有挑战性。农村退伍军人与城市退伍军人在提供循证治疗和实现血压控制方面存在差距。由于多种因素，成功的护理协调计划在农村地区的实施率可能较低。我们制定了一项人口层面的干预措施，以解决心血管疾病预防保健的多重障碍。
Uncontrolled blood pressure (BP) is common among Veterans. Rural Veterans are at risk for suboptimal care coordination as successful programs may be implemented at lower rates due to individual- and system-level factors. There is strong evidence to support the use of remotely delivered support and patient-generated data from home BP monitors and virtual BP visits to manage BP. The purpose of this project is to augment the current approach to addressing uncontrolled BP so that existing clinical staff can reach a larger patient population. Our project will address uncontrolled BP by leveraging team-based care, the Veteran's Health Administration Electronic Health Record, and patient-centered medical home data to address patient, provider, and system barriers to cardiovascular disease (CVD) preventive care. We will implement this project in cardiovascular disease practices in three rural Veterans Health Administration clinics. We will evaluate implementation processes as well as patient-level (e.g., clinical outcomes, referrals to specialty services) outcomes in a one-arm, pre-post design. This manuscript describes our process in expanding the implementation of a successful project to improve BP control in high-risk, rural Veterans. Findings from our study will inform an understanding of both implementation and clinical effectiveness outcomes of a potentially scalable BP intervention in rural, community-based clinics. Appropriate management of Veterans with uncontrolled BP can reduce morbidity and mortality related to CVD. In turn, improvements in BP, can lead to improved quality metrics and potentially decrease costs for a healthcare system. Uncontrolled blood pressure is common among rural Veterans as access to care may be challenging in rural settings. Gaps exist in the delivery of evidence-based treatment and in achieving blood pressure control in rural vs. urban Veterans. Successful care coordination programs may be implemented at lower rates in rural settings due to multiple factors. We developed a population-level intervention to address multiple barriers to cardiovascular disease preventive care.
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影响因子：
120.7
作者：
Bodenheimer, T;Wagner, EH;Grumbach, K
通讯作者：
Grumbach, K
影响因子：
3.6
作者：
Kravetz, Jeffrey D.;Walsh, Robert F.
通讯作者：
Walsh, Robert F.
农村，低收入高血压成年人的药物依从性：基于社区的多媒体干预的随机试验。
DOI：
10.4278/ajhp.090123-quan-26
发表时间：
2011-07
期刊：
American journal of health promotion : AJHP
影响因子：
--
作者：
Martin MY;Kim YI;Kratt P;Litaker MS;Kohler CL;Schoenberger YM;Clarke SJ;Prayor-Patterson H;Tseng TS;Pisu M;Williams OD
通讯作者：
Williams OD
影响因子：
37.8
作者：
Egan BM;Li J;Hutchison FN;Ferdinand KC
通讯作者：
Ferdinand KC
影响因子：
24
作者：
Narang, Akhil;Sinha, Shashank S.;Cullen, Michael W.
通讯作者：
Cullen, Michael W.