10 th Anniversary 2009-2019 Bonita Bobo, RN, HHS, KHDSP Program Manager Kari Moore, MSN, AGACNP-BC, SEQIP Chair Starr Block, MS, BSN, RN, The American Heart Association
Kentucky Background and the Role of KHDSP Bonita Bobo
Kentucky is in the Stroke Belt
Risk Factors: KY and the US 2017 Prevalence of Risk Factors Eat Fruit one or more times 63.2% 57.3% a day Eat Vegetables one or more 81.9% 83.0% times a day Health Care 89.5% 92.5% Access/Coverage 31.6% Obesity 34.3% US 10.5% Diabetes 12.9% KY Tobacco Use (Current 17.1% 24.6% Smoker) 33.0% High Cholesterol 38.1% 32.3% High Blood Pressure 39.4% 0% 20% 40% 60% 80% 100% Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data [online]. 2015. [accessed May 20, 2019]. URL: https://www.cdc.gov/brfss/brfssprevalence/.
Kentucky Heart Disease and Stroke Prevention Program (KHDSP) • Funding primarily through a grant from the Centers for Disease Control and Prevention (CDC) • The CDC focus strategies are: – to promote reporting of blood pressure and as able, initiate activities that promote clinical innovations, team-based care, and self-monitoring of blood pressure; – to promote awareness of high blood pressure among patients; – to increase implementation of quality improvement processes in health systems; – to increase use of team-based care in health systems; and – to increase use of health-care extenders in the community in support of self-management of high blood pressure.
Kentucky Heart Disease and Stroke Prevention Program (KHDSP) The Kentucky Heart Disease and Stroke Prevention State Action Plan 2017-2019 outlines objectives and strategies built on the dedication and collaboration among communities and healthcare professionals to address heart disease and stroke in the Commonwealth.
Strategic Map 2006-2009 Kentucky State Cardiovascular Health Plan Strategic Map: 2006-2009 Draft 06/26/06 Transform Kentucky’s Cardiovascular Health Approaches and Practices Expand Support and Implement Build Utilization of Expand Proven Secure Evidence-Based Policy and Evidence-Based Community- and Required Integrated CVH Legislative Prevention Site-based Funding Delivery Systems Support Strategies Interventions Identify, Prioritize Strengthen and Build Case for Action Increase Increase the and Disseminate Expand Workplace by Documenting Federal Funding Number of JCAHO Successful Wellness in Private CVH Impact on for HDSP and Certified Hospitals Prevention Practices Industry the Commonwealth Chronic Disease Develop, Prioritize Expand the Implement Clinical Educate Policy Secure State and Communicate Coordinated Pathways for All Makers on CVH Funding for Key Prevention School Health Non-Certified Points Costs, Solutions and HDSP and Messages Model of Service Economic Impact Chronic Disease Increase Public Expand Selective Establish and Develop and Increase Awareness of Successful Ensure Utilization of Disseminate Foundation and Modifiable Community-based EMS Transport Educational Tools Corporate Funding CVH Risk Factors Programs Protocols to Advocates for HDSP Implement Support Evidence- Build Legislative Proven Strategies Based Community Support Through for Translating Initiatives and National, State and Awareness into Action Disseminate Results Local Organizations Reduce Health Disparities and Address Needs of High-Risk Populations Strengthen Data Management, Evaluation and Reporting and Increase Its Effective Use Strengthen and Expand Collaboration and Partnerships
Strategic Map 2011-2016
Strategic Map 2017-2019 Kentucky Heart Disease and Stroke Prevention Task Force Strategic Map: 2017-2019 Improve Cardiovascular and Cerebrovascular Health for All Kentuckians. Secure Policy and Utilization of Evidence- Utilization of Evidence- Environmental Changes to Based Prevention Based Integrated Improve the Cardiovascular Strategies Cardiovascular Health (CVH) and Cerebrovascular Health of Kentuckians Delivery Systems Target health care systems and providers, worksites, schools, communities, and disparate populations . Conduct process and outcome evaluation. Cultivate and expand collaboration and partnerships to enhance community-clinical linkages. Explore the possibility of data information exchange and quality improvement efforts. Implement statewide Build support for the Enhance the knowledge Build support for CPR cerebrovascular and enactment of Promote and reinforce Promote effective at state level of heart training in schools. cardiovascular systems comprehensive state disease and stroke healthy behaviors and community-clinical of care. and local smoke-free B practice messaging. linkages. program . A1 A2 C1 C3 C2 policies. Update and continue to Improve statewide improve statewide cerebrovascular systems cardiovascular systems of care. B1 B2 of care. B1 B2
Strategic Map 2020-2023
February 2009 The Launch of SEQIP Starr Block
What Is SEQIP? • Stroke Encounter Quality Improvement Project (SEQIP) – Statewide Stroke Quality Improvement Initiative – Inspired by a stroke initiative in Colorado – Funded by converting unused CDC funds to launch the initiative (CDC approval was required) – Developed by the American Heart Association and HDSP, Kentucky Heart Disease and Stroke Prevention Taskforce – 3-year project to implement evidence-based stroke delivery systems and improve quality of care for stroke patients
Selection of Invited Hospitals Hospitals were selected based on these characteristics: • Geographic region assuring access to stroke care for ALL Kentuckians • Hospitals with highest number of hospital stroke discharges in the state who can affect stroke care quickly • Hospitals with an existing relationship with the AHA through the quality improvement program, Get With The Guidelines - Stroke
Top 25 Hospitals - Stroke Discharges (2008) Hospitals in Red were already participating in GWTG-Stroke and became the founding SEQIP members The 16 hospitals discharges equaled 59.7% of all stroke discharges in the state Source of this data is the Kentucky Hospital Inpatient Claims, 2018; Kentucky Cabinet for Health and Family Services, Office of Health Data & Analytics
MF1 Western Baptist Hospital, Paducah SEQIP HOSPITALS Baptist Hospital East, Louisville Owensboro Medical Health Park, Jewish Hospital, Louisville Kentucky Owensboro Norton Audubon Hospital, Louisville Norton Hospital, Louisville The Medical Center, Bowling Green 2008-2009 Norton Suburban Hospital, Louisville Lake Cumberland Regional Hospital, Sts. Mary and Elizabeth Hospital, Louisville Somerset University of Louisville Hospital, Louisville Pikeville Medical Center, Pikeville Kings Daughters Medical Center, Central Baptist Hospital, Lexington Ashland University of Kentucky Hospital, Lexington St. Elizabeth Medical Center, Edgewood Boone K e n Gallatin t o Carroll Grant n Mason Greenup Lewis Owen Robertson Harrison Henry Oldham Fleming Carter Nicholas Boyd Scott Franklin Shelby Rowan Bath Jefferson Woodford Elliott Lawrence Bourbon Fayette Spencer Menifee Clark Morgan Meade Bullitt Johnson Martin Powell Nelson Mercer Henderson Breckinridge Madison Wolfe Estill Magoffin Daviess Hardin Union Floyd Boyle Lee Pike Marion Breathitt McLean Larue Webster Lincoln Ohio Grayson Jackson Owsley Knott Taylor Casey Crittenden Perry Hopkins Hart Green Butler Clay Caldwell Letcher Leslie Laurel Pulaski Ballard Adair Warren Lyon Barren Christian Logan Knox Harlan Todd Carlisle Whitley Trigg Wayne Bell Allen Hickman Graves Simpson Monroe McCreary Calloway Fulton Geographic Location of Founding SEQIP Hospitals (2009)
SEQIP Profile • 16 Hospitals invited and recruited between June 2008 through April 2009 • 6 hospitals were certified as Joint Commission Primary Stroke Centers (PSC) • 3 Hospitals were actively seeking PSC Certification • 2,358 Patient Encounters from 7/1/08 to 4/3/09 entered into Get With The Guidelines-Stroke
Invitation to Participate
Let’s Get Started
SEQIP Inaugural Meeting Agenda • Discuss Stroke Measure Descriptions • Share best practices and encourage collaboration • Launch Kentucky’s First “Statewide Stroke Registry”
SEQIP Meeting Outcome • Shared best practices and encouraged unified collaboration • Decided to chose one measure to improve over the next year as a state (Ranked Top 3) • Developed an Action Plan with mechanisms to report successes to the group • Plan Next Steps for sharing progress: Teleconferences, F2F Meetings • Recruit Additional SEQIP Hospital Members
Dysphagia Screening KY SEQIP = 54.5%
Action Plan
Hospital Best Practices Presented Two Innovative QI Plans: • Hardin Memorial Hospital’s “Just Add Water” Dysphagia Project • Norton Hospital’s “NPO Until You Know” Dysphagia Project
Accountability and “Report Out” • Six Month Progress Reports received from All SEQIP Hospitals • Sharing of Best Practices on quarterly teleconferences • Shared what worked, discussed barriers and promoted new practice ideas
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