Coaching Louisiana Clinics for Higher Quality Primary Care
Submission Date: January 2018
State/Territory Submitted on the Behalf of: Louisiana
States/Territories Involved: Louisiana
Funding Source: CDC
CDC Funding:Yes
CDC Funding (Specified):(1305) State Public Health
Domain Addressed:Health Systems Strategies
Public Health Issue:- In the most recent America’s Health Rankings report, Louisiana ranked 49th lowest among all states, based on overall measures of health, with high rates of diabetes, cardiovascular deaths, and obesity.
- The Bureau of Chronic Disease Prevention and Health Promotion (BCDPHP) in the Louisiana Department of Health, Office of Public Health focuses on hypertension and diabetes through their Well-Ahead initiative which promotes best practices in primary care settings.
BCDPHP contracted with their Regional Extension Center, the Louisiana Health Care Quality Forum (Quality Forum), to coach staff at 10 Rural Health Clinic and Federally Qualified Health Center clinic sites to implement best practices.
Clinics identified a component of care related to hypertension and/or diabetes as a focus for improvement with the goal of collecting National Quality Forum (NQF) measures related to hypertension and diabetes control.
In initial meetings, Quality Forum practice coaches learned that some clinic electronic health records were either not set-up to or were incapable of producing the reports needed to guide the work. For this reason, the scope of the work expanded to include recommendations and training on generating these reports and utilizing the NQF measures. Clinics also tracked process measures such as A1C screenings, eye exams, and patient education.
Coaches shared policy and process recommendations, along with training and tools for implementing them, to help clinics best address their selected objectives.
Impact/Accomplishments:All 10 clinic sites produced at least one report on hypertension and diabetes control measures by the end of the intervention. Most participating clinics performed a chart audit or added data to an existing patient registry to enable them to assess outcomes in an area needing improvement.
Process measures assessed at three sites demonstrated clear improvement in delivering recommended tests, for example:
- Patient’s receiving recommended annual tests increased from 9% to 19% for eye exams; from 9% to 36% for microalbumin tests; from 62% to 66% for lipid panels; and from 33% to 41% for electrocardiograms.
This project helped clinics assess their needs and establish goals and action plans that they can implement within their existing systems.
BCDPHP continues to work with the Quality Forum to increase engagement by implementing coaching at fewer clinic sites and offering a small incentive payment for participation to help clinics prioritize the work and engage more fully with the resources offered by the practice coaches.
Program Areas:Healthy Communities (general)
State Contact Information:
LA
Marie Darr
Louisiana Department of Health
225-412-1562
Marie.darr@la.gov