Hiding In Plain Sight (HIPS) Strategy La Maestra Community Health Centers

HIPS Strategy La Maestra Community Health Centers Use of the Algorithm: Pre-visit, during the visit and Post-visit actions 1. Run i2i Report quaterly: Patients with 2 medical visit in the past year with 2 BP reads > 140 or >90 or >140/90 2. Check if any of these patients have upcoming apt. If not, recall patients to come back for follow up. 3. Flag patients chart and inform the provider . Pt belongs to Million Hearts Initiative 3. Provider will see pt and order proper follow up/labs 4. Determination of diagnosis: 1. HTN 2. Elevated BP Patient diagnosed with HTN : 1. Health Education 2. Pharmacist for Med education/reconciliation

HIPS Strategy La Maestra Community Health Centers Training to ensure Blood Pressure accuracy: Patient should be relaxed Sleeve should be rolled up. Locate Brachial Pulse. Right placement of the cuff

HIPS Strategy La Maestra Community Health Centers The cuff should be about 1 inch (2.5 cm) above the bend of your elbow and should be evenly tight around your arm. Inflate the cuff Deflate the Cuff

HIPS Strategy La Maestra Community Health Centers La Maestra Policy

Hypertension Protocol Status Connecting to the Larger QI Picture Topic/ Change Idea Category QI Change Concept Resources Running quarterly reports to proactively identify patients. Our efforts are part of the population management. It addresses multiple QI concepts: Staff Training Data driven Improvement Optimize encounter HIPS strategy Algorithms. Hypertension diagnosis protocol. Delete the example and replace with your own content Where does your topic/change idea fit into the larger QI picture (refer to slide 2)? Category: Is the change idea a key foundation, is it part of population health management, or is it an individual patient support? QI Change Concept: What general QI change concept does it best relate to (e.g., staff training, use evidence- based guidelines and protocols, use data to drive improvement, optimize intake and waiting, optimize the encounter, etc.) If you feel your topic fits into a QI change concept not listed on slide 2, please add it where you feel it best fits. If it addresses multiple QI Change Concepts, indicate that as well. Resources: What resources best support this change idea?

Hypertension Protocol Status CDS 5 Rights Analysis Information Person Format Channel When in Workflow Actively looking for patients that were HIP. MA RN Providers QI team Reports Verbal Communication EHR I2i Track system Face to Face meetings Population Health Management. The five rights include: the right information, to the right person, in the right intervention format, through the right channel, at the right time in workflow Please answer these questions as they relate to your selected topic/change idea. What was the information? Who received/used, produced, acted upon, and/or communicated it? What format was it in (e.g. alert, protocol, patient monitoring system, report, verbal communication, etc.) Through what channel (EHR, data warehouse, paper, physical object, telephone, face-to-face meeting, etc.) Where in the workflow (or was this foundational or population health?)

Hypertension Protocol Status Change Idea in Action Include any relevant screen shots, photos of teams, etc., as they relate to your topic Provide an overview of how it works, if not already clear from the previous slide.

Hypertension Protocol Status Keys to Success Critical success factors: Inform providers (Even if you have a provider champion) Engagement and training (if need it) of clinical personal. Support from financial department and executive team Resources required: Reporting tool Personal (Clinical and QI ) Budget (to make sure we covered the visit of the un-insured patients) Please answer these questions as if you were teaching another health center how to implement this specific change idea/intervention (remember, there will be health centers in the audience who may be interested in participating next year and there will be representatives from the CDC, HRSA, etc.). Slide point should be no smaller than 18, ideally 20. Break content into multiple slides, if needed.

Thank You Sonia C Tucker Quality Improvement Director stucker@lamaestra.org 619-997-5822.