Heart Healthy Ohio Initiative Project Update
By: Caroline Carter, Chief Transformation Officer, Health Impact Ohio
HHOI Background
Ohio is in the top quartile of states for high cardiovascular disease (CVD) event rates (i.e. combined stroke and heart attacks). Ohio has a high adult prevalence of 2 key modifiable CVD risk factors: hypertension (35%) and smoking (21%). A third key modifiable CVD risk factor is cholesterol medication taking in those at elevated cardiovascular risk. It is estimated that 50% of people take cholesterol medications as prescribed. Improving blood pressure (BP) control, cholesterol medication taking, and smoking cessation should strongly improve CVD events in Ohio.
50 diverse primary care practices across the state are participating in the Heart Healthy Ohio Initiative (HHOI) focused on hypertension management, cholesterol medication taking, and smoking cessation. As part of this project, we are partnered with payers, public health agencies, and other stakeholders with the goal of aligning efforts to improve cardiovascular health outcomes. As we learn successful strategies around cardiovascular health improvements, we will work to disseminate findings throughout Ohio.
Three practices were recruited as ‘pilot’ practices and agreed to collaborate and help design the QIP. They are referred to as the co-design sites. With their guidance the brown colored key Drivers and Change Strategies were added to the Key Driver Diagram.
Each of the co-design sites had access to a Quality Improvement (QI) Coach for 1-year. Coaching included: monthly QI Coaching calls, quality improvement methodology instruction, and support and guidance with designing and implementing quality improvement initiatives designed to support the projects’ SMART Aims.
Initial findings:
Two of the 3 codesign sites which started with lower blood pressure control improved their blood pressure control over the 1-year period by 5-10% depending on the site. The third site transitioned to a new electronic medical record resulting in challenges submitting data. (blue line). We note that their trajectory looked similar to the other co-design sites.
The sites primarily focused on establishing standardized protocols for accurate blood pressure measurement and timely follow-up visits in team-based care until the blood pressure was controlled.
They have recently begun working more actively on smoking cessation efforts with patients and anticipate further improvements with connecting patients to smoking cessation resources over time.
Learn more about the Heart Healthy Ohio Initiative here: https://hearthealthyohio.org.