1. IMPROVING DIABETES AND HYPERTENSION FEBRUARY 26, 2015 SUE BUTTS-DION, IMPROVEMENT ADVISOR Maine Chronic Disease Improvement Collaborative (CDIC) QI Team Space & Preparation for Team Report Out & Sharing

2. Paul Batalden, MD Senior IHI Fellow All improvement requires change AND All change is not necessarily an improvement. “Everyone in healthcare really has two jobs when they come to work every day: to do their work and to improve it.”

3. To increase odds that change is improvement… Aim Measures Change Ideas Test Ideas Measure(s) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 12345678910111213141516171819202122232425 weeks Percent

4. CDIC: How it Works Aim: By end of the pilot, have supported the practices to: Improve blood pressure control of hypertensive patients so that 65% of hypertensive patients have BP<140/90 mm Hg. Improve HbA1c control of diabetic patients so that 80% of diabetic patients most recent HbA1c level is <9.0% during the measurement year. Measures: (variable based on MOC participation) Outcome Measures: HTN BP Control (<140/90) (NQF 18) and/or LDL <100 (NQF 0064) DM A1c Control (>9%) (NQF 59) and/or a1c <8% (NQF 0575) Process Measures: Registry Use Population Mgmt Pre-Visit Planning Self-Management PlanReferral Other (e.g., assessment results)

6. Change Ideas (See Handout)

7. Testing

8. Rapid Cycle, Small Scale Testing

10. How Big or Small to Test??

11. Test Changes

12. QI Teamspace

13. Team Report Outs & Sharing Huddle with your team to review and update Storyboards (10-15 minutes) Present your “story” to other teams  Aim  What you have been working on since December  Any results in measures?  What you are working on (testing) and plans of what you will work on next? Q & A and Review of Key Points

14. Questions?