3. 4:55-5:00 Cross-Pollination/Ideas with other RHIP Workgroups All Reproductive Health/Maternal Child Health Oral Health Milestones to Health

Transcription

1 RHIP Clinical Cardiovascular Disease Workgroup Deschutes County Building (Lyon Room) 1300 NW Wall Street, Bend Agenda: October 23, 2018 from 4:00-5:00pm Goals Clinical Goal: Improve hypertension control Prevention Goal: Increase awareness of the risk factors for cardiovascular disease including tobacco use, uncontrolled hypertension, high cholesterol, obesity, physical inactivity, unhealthy diets, and diabetes. Health Indicators by Increase the percentage of OHP participants with high blood pressure that is controlled (<140/90mmHg) from 64% to 68% (Baseline: QIM NQF Controlling high blood pressure, 2014). 2. Decrease the prevalence of cigarette smoking among adults from 18% to 16% (Baseline: Oregon BRFSS, ; QIM Cigarette Smoking Prevalence). 3. Decrease the prevalence of smoking among 11 th and 8 th graders from 12% and 6%, respectively to 9% and 3%, respectively (Baseline: Oregon Healthy Teens Survey, 2013). 4. Decrease the prevalence of adults who report no leisure time physical activity from 16% in Crook County, 14% in Deschutes County and 17% in Jefferson County to 14%, 12%, and 15 % respectively (Baseline: Oregon BRFSS, ). 5. Decrease the prevalence of 11 th graders and 8 th graders who 0 days of physical activity from 11% and 6% to 10% and 5%, respectively (Baseline: Oregon Healthy Teens, 2013). 1. 4:00-4:05 Introductions All QIM Measure State Measure 2. 4:05-4:55 Next Steps: Blood Pressure Awareness/Control A3 All Clinical Champion Provider & Community-Based Presentations RFP for Blood Pressure Messaging 3. 4:55-5:00 Cross-Pollination/Ideas with other RHIP Workgroups All Reproductive Health/Maternal Child Health Oral Health Milestones to Health 4. 5:00 Action Items & Announcements All Next steps Healthy People 2020 ` Next Meeting: from 4-5pm (Deschutes County Bldg. (Lyon Room) 1300 NW Wall St., Bend) 1

2 Cardiovascular Disease: Clinical (9) Karen Ard Mark Backus, MD, FACP Stevi Bratschie, MPH Brenna Francis Maria Hatcliffe, RN, MPH David Huntley, MPH Alison Little, MD, MPH Robert Ross, MD, MScED, FAAFP Shiela Stewart, RN, BSN Kris Williams Organization Deschutes County Health Services Cascade Internal Medicine Specialists PacificSource La Pine Community Health Center Mosaic Epidemiologist - Community Member PacificSource St. Charles Health System/St. Charles Medical Group Central Oregon IPA Crook County Health Department 2

3 Current Date: Event Date: Description: Sponsor: Hypertension A3 COHC Value Stream ID: Process Owner/Team Lead: Site / Location: Facilitator: 1: REASONS FOR ACTION Go No Go 4: GAP ANALYSIS Go No Go 7: COMPLETION PLAN Problem: Central Oregon adults are damaging their bodies and dying because of high blood pressure. According to the CDC about 1 of 5 U.S. adults with high blood perssure still do not know they have it. Please see attached fishbone diagram. Clinical CVD Rebeckah Berry Sensei: Event Number: Please see attached completion plan. Revision: Go No Go Team Members: Aim: 80% of Central Oregon adults will have their blood pressure in control (<140/90 mmhg) Boundaries: Central Oregon, adults 2: INITIAL STATE Go No Go 5: SOLUTION APPROACH Go No Go 8: CONFIRMED STATE 65% of adult Medicaid patients have high blood pressure in control.* 1. If we implement a population-wide/regional messaging campaign, then we expect an increase in Central Oregonian adults to know and understand the importance of managing their blood pressure. Go No Go 65.4% of adult Medicaid patients have high blood pressure in control.* 2. If we continue/broaden reach of clinical champion blood pressure control presentations, then we expect a greater number of patients who have high blood pressure to move to in control 1 *CO CCO QIM rate: June : TARGET STATE: Go No Go 6: RAPID EXPERIMENTS Go No Go 9: INSIGHTS *As of July 2018 Go No Go % of adult Medicaid patients have high blood pressure in control. 1. Population-wide/regional messaging campaign to know your blood pressure and what do to if it s high (i.e. see/establish care w/ PCP) Broaden clinical champion blood pressure control presentations (businesses, urgent cares, health students, dental, public health, VIM, etc.)

4 P ossible C hallenge CVD CLINICAL: HYPERTENSION BOX 4 FISHBONE DIAGRAM I mplement K ill WHAT could help us reach our aim? HOW do we solve it? Increase support structures to lower BP General Education K- Vegetable/fruit access I- Messaging/marketing campaign C- Exercise/ other lifestyle I modification opportunities K- Increase access to health care C K- Engage jurisdictions in built I- BP screens & next steps environment supports for physical P- Focus groups activity C- Decrease alcohol, tobacco & obesity I- Self-management opportunities (home BP monitoring, relaxation, etc.) C K- Grocery story/ restaurant participation (DASH diet) - Community events (Community health centers, senior centers, wellness centers, and churches) AIM 80% of Central Oregonian adults will have their blood pressure in control (<140/90 mmhg) Primary Care Initiatives C- Small group health coaching C- Team-based care development I- Population health/ panel management I- Standardize BP Measurement I- Clinical protocols Provider Education I- Teach Motivational Interviewing I- Patient/clinic education materials I - Clinical champion presentations (ortho, dental, public health, VIM, urgent care, health students) Workplace Wellness I- Employer & employee education I- BP screens I- Incentivize controlling/lowering BP 4

5 CVD Clinical Box 7 Completion Plans: MARKETING CAMPAIGN ACTION ITEM ASSIGNEE DUE STATUS Create RFP for marketing Clinical CVD Dec 2018 agencies to respond to Workgroup Send out RFP Rebeckah Dec 2018 Review RFP & select Clinical CVD Feb 2019 Awardee Workgroup Provide T.A. to media Clinical CVD Jun 2019 awardee for messaging/ development Workgroup Launch Campaign Marketing Firm Jun 2019 CLINICAL CHAMPION PRESENTATIONS ACTION ITEM ASSIGNEE DUE STATUS Create/Refine general Dr. Mark Nov 2018 population presentation Backus Apply for funds Dr. Backus / Jan 2019 COIPA Begin scheduling talks to providers & general populations Dr. Backus / COIPA Feb 2019 Report on progress to workgroup Dr. Backus / COIPA May

6 Appended Guidance to Regional Health Improvement Plan Workgroups Workgroups can expend up to $5k on expenses/investments without an A3. If one or more workgroups seek to cross-collaborate, at least one of the participants must have an A3 supporting the ask. The partnering workgroups can provide matching funds, at their discretion without an A3, up to the amount of their remaining seed money. 6

7 COHC Summer 2018 RHIP Updates Behavioral Health Identification & Awareness AIM: Identify and engage 100% of individuals in Central Oregon that have a behavioral health need, and ensure an effective and timely response. Implemented a two-year project: a behavioral health (BH) integration specialist has been hired to collaborate with all primary care (PC) clinics regionwide to support universal screening for BH as well as guidance for PC clinics to address BH screens based on clinic capacity. Behavioral Health Substance Use & Chronic Pain AIM: All Central Oregonians with an SUD that enter the hospital system including the ED will receive engagement, treatment, or harm reduction services. Initiated a two-year pilot in the Bend St. Charles Hospital and ED to house a substance use disorder (SUD) coordinator and a recovery mentor to support screening and follow-up for patients with moderate-to-severe SUD. Cardiovascular Disease & Diabetes Prevention AIM 1: Cost will never be a barrier to participate in a variety of physical activities for students. AIM 2: By % of adults in Central Oregon will have a diet modifiable disease, specifically CVD and/or type 2 diabetes. Opened RFP to develop a regional model for provider-based referrals for physical activity for youth through Rx to Move. Finalized their Box 6 experiments for their new Nutrition A3. Cardiovascular Disease Clinical AIM: Reduce the rate of youth tobacco use in Central Oregon from 17.3% to 15% in 8th graders, and 23.2% to 20% in 11th graders. Started a new A3 focused on community-wide education for blood pressure awareness and control. Completed a document outlining tobacco cessation insurance coverages currently being shared with provider groups regionally. Diabetes Clinical AIM: 95% of Central Oregonians with Type 2 Diabetes will have an HbA1c of < 9% Prepared for algorithm of care events with national speakers on the gut microbiome with diabetes, and teambased care models. Events will be held in Madras, Prineville and Bend. The Central Oregon Health Council Summer 2018 RHIP Workgroup Updates 7

8 Oral Health AIM: Improve Oral Health and keep children cavity free. Brainstorming Box 6 experiments in two new A3s one on integration and another on geriatric care. Released RFP for MORE Care model from Dentaquest, which integrates oral health into PC. Reproductive Maternal Child Health AIM: Prevent Unintended Pregnancies Reviewed the BOOST Oregon initiative, a parent-led group promoting child immunizations. SDOH: Housing AIM 1: Central Oregon communities have sufficient, actionable data to guide direction, establish priorities, support regional solutions, and bring a call to action to mobilize citizens to create a healthier Central Oregon. AIM 2: The approximately 200 chronically homeless and/or high utilizers in Central Oregon will be stabilized and supported to achieve well being. Funding: $60,000 for Pfeifer & Associates for their House the Children initiative which provides a safe, supervised home for children to share with their parents who are in treatment and maintaining sobriety. SDOH: Milestones to Health & Education AIM 1: Central Oregon children become more resilient AIM 2: Every Central Oregonian thriving in the face of diversity AIM 3: Children in Central Oregon have lifelong health and learning challenges due to lack of early identification and access to services AIM 4: Every child in kindergarten has the early literacy skills to be ready to learn Nurturing 3 subgroups: Literacy, Social and Emotional, Access to Integrated Services (TRACEs part of Social and Emotional subgroup) Literacy team partnering with Equity Team around reading program ask. The Central Oregon Health Council Summer 2018 RHIP Workgroup Updates 8