May 2015 Campaign Updates
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- Derek Abel Poole
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1 May 2015 Campaign Updates
2 Release of new campaign materials for NHBPEM National Day of Action: Roll Up Your Sleeves! Roll Up Your Sleeves! Health Expo
3 New Campaign Materials
4 Choose Your Path Patient Video
5 It Takes a Team Provider/Staff Video
6 Health Disparities Factsheets
7 National Day of Action: Roll Up Your Sleeves!
8 May 7: National Day of Action
9 As of May 13 th National Day of Action Participants Accredited Home Care Affinity Medical Group Allegan County Building Ties American Diabetes Association American Diabetes Association's Buffalo Office American Heart Association American Heart Association Alabama Region American Heart Association Greater Washington Region American Journal of Managed Care American Kidney Fund American Medical Association American Medical Group Association American Medical Group Foundation American Society of Hypertension Anceta LLC Arch Health Partners AtCor Medical Atrius Health Austin Regional Clinic Baptist Medical Group Baylor Health Care System/HealthTexas Provider Network Bend Memorial Clinic Billings Clinic BlueCare Tennessee BodyCraft Brown & Toland Physicians Cardiopulmonary Rehabilitation at Southern New Hampshire Medical Center Caribbean Cardiac Carle Physician Group CHANGE, Inc. Choice Medicine Colorado Springs Health Partners DC Fire & EMS DC Health Link Defeat Diabetes Foundation District of Columbia Department of Health Dodge Communications Employer Services Enduring Hearts Erie Family Health Center-Helping Hands Esse Health Essentia Health Evans Blount Healthcare Express Scripts Fatherhood.gov Florida Medical Clinic Greater Washington Hispanic Chamber of Commerce Group Health Cooperative of South Central Wisconsin Hager Sharp Harvard Vanguard Medical Associates Healthcare Financial Management Association South Carolina HealthyWomen Heffelfinger & Associates Henry Ford Medical Group Home Health Quality Improvement National Campaign Innovative Health Solutions Innovative Health Solutions Inova Health System Inova Medical Group Intermountain Health JCF Corp. Jefferson Healthcare Johns Hopkins Center to Eliminate Cardiovascular Health Disparities Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality Maine Center for Disease Control & Prevention Mango Health Marshall B. Ketchum University Mayo Health Systems McDonald's Restaurants of the Tri-State Area (WV/KY/OH) Measure Up/Pressure Down MedStar Family Choice MedStar Franklin Square Medical Center Department of Family Medicine Men's Health Network Mercy Clinics East Division MI Express Care Million Hearts Million Hearts Delaware Ministry Medical Group
10 As of May 13 th National Day of Action Participants Nantucket (MA) Health Department National Organization of Nurses with Disabilities NEA Baptist Clinic New Jersey Medical School Alumni Association New West Physicians Northeast Georgia Health System Nothing But The Best Olmsted Medical Center Palo Alto Medical Foundation Premier Medical Associates Prevea Health Preventive Cardiovascular Nurses Association PriMed Physicians ProHealth Physicians Providence Hospital Fort Lincoln Family Medicine Center Quincy Medical Group Ralphs Redwood Community Health Coalition Referral MD Right Care Initiative Sacred Heart Hospital Pensacola Santa Clara County (CA) Public Health Sharp Rees-Stealy Medical Group Slocum-Dickson Medical Group PLLC Somerset County (NJ) Department of Health Southern New Hampshire Health System Springfield Clinic StrategicHealthSolutions Summit Medical Group Swedish American The Everett Clinic The Iowa Clinic The Polyclinic ThedaCare Physicians Tulane University Medical Group United Health Foundation United Way of Monroe County Unity Health Care UnityPoint Clinic University of Maryland School of Pharmacy's APhA-ASP Operation Heart University of Utah Healthcare Community Clinics US Department of Health and Human Services, Region II Office of the Assistant Secretary for Health USMD Utah Hospital Association VNA Care Network & Hospice Voices For Health Watson Clinic Weill Cornell Physician Organization Welch Allyn Well3 Pikes Peak Wellmont Medical Associates WESTMED Medical Group Withings WomenHeart: The National Coalition for Women with Heart Disease West Virginia Bureau for Public Health - Division of Health Promotion and Chronic Disease Wyoming Department of Health YMCA of Metropolitan Washington
11 National Day of Action Impact Report your plans to
12 Roll Up Your Sleeves! Health Expo
13 Roll Up Your Sleeves! Health Expo
14 Other Campaign Activities
15 Q Reporting Open Q data is currently accepted through the campaign portal To report your data, please visit: Q Reporting Deadline: June 30, 2015
16 2015 Institute for Quality Leadership Conference
17 Sacramento Family Medical Clinics Dr. Gilbert Simon Medical Director
18 Why hypertension is top priority Common denominator risk factor High prevalence Poor control rate Good BP control = Decreases mortality
19 Small Reductions in Systolic BP Can Save Many Lives Reduction in BP, Mm Hg % Reduction in Mortality Stroke CHD Total Whelton, PK, et al. JAMA. 2002;288:1882; Stamler R, et al, Hypertension. 1991:17:I 16.
20 Best Practice: Measure Up Pressure Down JNC Guidelines: Measure Up, Pressure Down:
21 What worked, what didn t
22 What worked, what didn t Direct Care Staff Trained in Accurate BP Measurement
23 What worked, what didn t Hypertension Guideline Used and Adherence Measured
24 What worked, what didn t BP Addressed for Every Hypertension Patient, Every PC Visit
25 What worked, what didn t All Patients Not At Goal and with New Rx Seen within 30 Days
26 Office Manager s Script for No-Shows Can you come in today for a blood pressure check? Tomorrow, then? This is why we have to lower your blood pressure: Every point we lower makes you healthier. 20 points off the top number cuts your risk of a heart attack in half. If your pressure stays where it is, you have one chance in six of dying in two years.
27 What worked, what didn t Prevention, Engagement, and Self- Management Program in Place
28 Say What? How Written Instructions May Appear Your naicisyhp has dednemmocer that you have a ypocsonoloc. Ypocsonoloc is a test for noloc recnac. It sevlovni gnitresni a elbixelf gniweiv epocs nto your mutcer. You must drink a laiceps diuqil the thgin erofeb the noitanimaxe to naelc out your noloc.
29 Health Literacy What is it and why does it matter THE DEGREE TO WHICH INDIVUALS HAVE THE CAPACITY TO OBTAIN, PROCESS AND UNDERSTAND BASIC HEALTH INFORMATION AND SERVICES NEEDED TO MAKE APPROPRIATE HEALTH DECISIONS. POOR HEALTH LITERACY IS A STRONGER PREDICTOR OF A PERSON S HEALTH THAN AGE, INCOME, EMPLOYMENT STATUS, EDUCATION LEVEL AND RACE. SOURCE: AMA REPORT: HEALTH LITERACY AND PATIENT SAFETY: HELP PATIENTS UNDERSTAND
30 IMPACT OF LOW HEALTH LITERACY THOSE THAT HAVE LOW HEALTH LITERACY COST 4 TIMES AS MUCH AS THOSE WITH HIGH LITERACY, AND ACCOUNT FOR BILLION DOLLARS/YEAR OR 3-5% OF TOTAL COST HOSPITALIZATION RATES ARE 50% HIGHER IN LOW HEALTH LITERATES MAKE MORE MEDICATION ERORS LESS LIKELY TO COMPLY WITH TREATMENTS LACK THE SKILLS NEEDED TO SUCCESSFULLY NEGOTIATE THE HEALTH CARE SYSTEM SOURCE: NATIONAL PATIENT SAFETY FOUNDATION.
31 Health Literacy Office of Disease Prevention and Health Promotion Health Communication Activities Health Literacy Level Task Examples Percentage Proficient Intermediate Basic Using a table, calculate an employee's share of health insurance costs for a year. Read instructions on a prescription label, and determine what time a person can take the medication. Didn t work Below Basic Read a pamphlet, and give two reasons a person with no symptoms should be tested for a disease. Read a set of short instructions, and identify what is permissible to drink before a medical test. 12% 53% 21% 14% Source: U.S. Department of Education, Institute of Education Sciences, 2003 National Assessment of Adult Literacy.
32 Health Literacy (cont d) Age Below Basic Basic Intermediate Proficient % 20% 56% 13% % 22% 53% 12% % 28% 44% 5% Over 75 39% 31% 29% 1% Source: U.S. Department of Education, Institute of Education Sciences, 2003 National Assessment of Adult Literacy.
33 Health Literacy (cont d) Insurance Source Below Basic Basic Intermediate Proficient Employer Provided 7% 17% 62% 14% Military 12% 21% 56% 11% Privately Purchased 13% 24% 54% 9% Medicare 27% 30% 40% 3% Medicaid 30% 30% 37% 3% No Insurance 28% 25% 41% 6% Source: U.S. Department of Education, Institute of Education Sciences, 2003 National Assessment of Adult Literacy.
34 MOTIVATIONAL CONVERSATION Objective: To encourage patient to discuss their personal barriers to changing their behavior by a four step process: 1) asking strategic questions and then listening reflectively and empathically 2) assessing readiness to make changes 3) obtaining permission to introduce information 4) ending with an encouraging summary of visit.
35 Strategic Questions If you keep doing what you re doing, how do you see things turning out? What do you think you re doing that isn t so good for you? How would your life be different if you weren t doing it? What would you need to change to achieve your goals How can I help you succeed?
36 Expressions of empathy I know how hard it is. I understand what you re saying I can only imagine how hard that must be for you.
37 Assessment of Readiness Ask on a scale of 1-10, how important is it for you to stop smoking, lose weight, keep appointments, take meds, etc.. If low number, say I guess this isn t important to you right now but I am here for you when you are ready. If number is medium, ask what would it take to get you to a higher number. If high, say can I make a few suggestions now?
38 Asking for permission There are a few things we can do to help you. Would you like to hear about them? Would you like to know why I think you are having trouble losing weight(stopping smoking, taking medications)? May I give you my opinion(thought) (ideas)? I d like to discuss treatment options with you. Would that be OK? Would you like to hear more about it?
39 Summation with praise These are some of the solutions we have talked about. Tell me in your words what you are going to do. How much do you think is possible to accomplish between now and our next visit? Wonderful. Good job!
40 A GOOD DOCTOR LISTENS
41 Results: Patients
42 Case Study One Almost 70 y/o Latino man with DM, COPD, HTN, Obesity, intolerance to ACE inhibitor 3/12/14 Visit one, a walk-in: BP 176/88, 186/94 Off medications PCP obtained Micardis/HCT 40/12.5 by requesting prior authorization 3/26/14 First follow-up with MA BP 156/96 RX changed to Micardis/HCT 80/25 4/18/14 Second follow-up with MA BP 138/64
43 Case Study Two 55 y/o woman with chronic hip pain, HTN 12/18/12 Visit one: BP 140/96, taking Amlodopine 5 and Triamterine/HCTZ 37.5/25 8 Visits BP 140/112, Amlodopine increased to 10 2/7/14 New clinician BP 140/112, Lisinopril added 3/7/14 BP 100/62
44 Dr. Gilbert Simon Questions?
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