Blood Pressure Management: An Improvement Story Annie Sy, PharmD, - - PowerPoint PPT Presentation

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Blood Pressure Management: An Improvement Story Annie Sy, PharmD, - - PowerPoint PPT Presentation

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Blood Pressure Management: An Improvement Story Annie Sy, PharmD, MHSA Director, SMF Integrated Quality Services Capital Region Right Care Initiative University of Best Practices Meeting October 8, 2018 Sutter Medical Foundation Theresa Frei

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Blood Pressure Management: An Improvement Story

Annie Sy, PharmD, MHSA Director, SMF Integrated Quality Services Capital Region Right Care Initiative University of Best Practices Meeting October 8, 2018

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Sutter Medical Foundation

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Physician Partners

  • Sutter Medical Group (SMG)
  • Sutter North Medical Group (SNMG)
  • Sutter Independent Physicians (SIP)
  • Aligned MDs:
  • Medical Groups: 1000+
  • SIP: 541

Site Specifics

  • Sutter Surgical Hospital – North Valley
  • Care Centers: 84 locations
  • Surgery Centers: 2 locations
  • Diagnostic Imaging: 45 locations
  • Lab: 30 locations
  • Physical Therapy: 15 locations
  • Sutter Walk-In Care: 4 locations

2017 Quick Facts

  • Active Patients: 890k
  • 2017 Employees: 3,400

Theresa Frei

CEO Years in Position: 3 Years with Sutter: 15

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Where We Were

  • In 2016, among 36,626

SMF patients with hypertension and/or diabetes, only 66% had their blood pressure (BP) under control

  • Top reason was failure to

review and act on results

– Only about 48% of patients with elevated BP were being addressed during clinic visits

SMG SNMG SIP Total Measure Rate 65.84% 71.88% 61.07% 65.97% P90 Benchmark 80.50% 80.50% 80.50% 80.50% P50 Benchmark 68.50% 68.50% 68.50% 68.50% Denominator 29,113 3,755 3,758 36,626 0% 20% 40% 60% 80% 100% Performance by Group (Data Through 12/31/2016)

Measure Definition: The percentage of members 18–85 years of age who had a diagnosis of hypertension, or 18-75 years of age with diabetes, and whose most recent BP within the past 12 months was adequately controlled according to the appropriate criteria based on their age and diabetic status.

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What We Did

  • Monthly performance

reports, with data at care center and physician levels

  • Hypertension guideline and

measure FAQs

  • BP measurement

training/education

  • Standard workflow to take

second BP if first one is high

  • Improve documentation

(Vitals, CPT-2 codes)

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What We Did

  • Visual cues for PCPs for

patients with elevated BP levels during clinic visits

  • Engage specialists
  • Telephonic Disease

Management engagement

  • Outreach efforts (e.g.,

patients without follow up appointments)

  • Link it to patient wellbeing

and decrease risk of cardiovascular events

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Care Center Highlight: Davis Family Practice Group

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Where We Are

  • Since 12/31/2016:

– Overall BP control rate increased from 66% to 79% – About 4,218 more SMF patients have their BP under control

  • Number Needed to Treat (NNT) for

BP-lowering treatment to prevent

  • ne CVD event in 5 years is

between 26 (highest risk group) and 71 (lowest risk group)1

SMG SNMG SIP Total 12/31/2016 65.84% 71.88% 61.07% 65.97% 8/31/2018 79.47% 77.24% 75.27% 78.85% P90 Benchmark 80.50% 80.50% 80.50% 80.50% P50 Benchmark 68.50% 68.50% 68.50% 68.50% 0% 20% 40% 60% 80% 100% % of Patients with BP Under Control

1 Estimated based on results from: Blood Pressure Lowering Treatment Trialists' Collaboration, Sundström J, Arima H, et al. Blood pressure-lowering treatment based on

cardiovascular risk: a meta-analysis of individual patient data. Lancet 2014; 384:591. Measure Definition: The percentage of members 18–85 years of age who had a diagnosis of hypertension, or 18-75 years of age with diabetes, and whose most recent BP within the past 12 months was adequately controlled according to the appropriate criteria based on their age and diabetic status.

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65.97% 78.85%

50% 60% 70% 80% 90%

% of Patients with BP Under Control

Blood Pressure Control in Patients with Hypertension and/or Diabetes (Rolling 12-Month Data)

SMG SNMG SIP Total P90 Benchmark P50 Benchmark

Measure Definition: The percentage of members 18–85 years of age who had a diagnosis of hypertension, or 18-75 years of age with diabetes, and whose most recent BP within the past 12 months was adequately controlled according to the appropriate criteria based on their age and diabetic status.

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Success Ingredients

  • Leadership champions
  • Clinician engagement
  • Care team support
  • Standard workflows
  • Visual management
  • Leverage friendly competitions
  • Recognize achievements
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Questions / Comments / Feedback

Annie Sy, PharmD, MHSA Director, SMF Integrated Quality Services Chair, SMF Quality & Patient Safety Committee (916) 731-7848 | Direct (916) 521-2591 | Mobile SyAZ@sutterhealth.org

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