Health Quality Innovators

HIT EXTENSIONS CENTERS - 3012 - VIRGINIA HIT REGIONAL EXTENSION CENTER

TRANSFORMING CLINICAL PRACTICES INITIATIVE - PTN

THE RICHMOND, VA, ACCOUNTABLE HEALTH COMMUNITY ("RVA-AHC")

INCREASING EQITY IN DIABETES PREVENTION, EDUCATION & CARE FOR PRIORITY POPULATIONS IN SOUTHEASTERN VIRGINIA - COMPONENT B, SOUTHEASTERN VIRGINIA BACKGROUND: THE IMPACT OF DIABETES AND PREDIABETES IN VIRGINIA IS MARKEDLY WORSE IN THE STATE’S SOUTHEASTERN REGION. IN THE CITIES OF HAMPTON (137,746) AND NEWPORT NEWS (184,587), ABOUT 18% OF THE POPULATION HAS DIABETES AND ABOUT 15% HAS PREDIABETES, WHILE IN RURAL NORTHAMPTON (12,085) AND ACCOMACK (33,246) COUNTIES, MORE THAN 21% OF THE POPULATION HAS DIABETES AND ABOUT 15% HAS PREDIABETES. IN THESE FOUR LOCALITIES, THE BLACK POPULATION COMPOSES FROM 30% TO 45% OF THE TOTAL POPULATION, COMPARED TO 20% OF THE VIRGINIA POPULATION. THE PREVALENCE OF DIABETES IS HIGHER IN VIRGINIA’S BLACK POPULATION (17.5%) THAN IN THE WHITE AND HISPANIC POPULATIONS (BOTH 10%). PURPOSE: HEALTH QUALITY INNOVATORS (HQI), WITH COMPONENT B FUNDING, WILL REDUCE DIABETES-RELATED HEALTH DISPARITIES FOR THE BLACK AND HISPANIC PRIORITY POPULATIONS IN HAMPTON AND NEWPORT NEWS, AND FOR THE BLACK, HISPANIC AND RURAL PRIORITY POPULATIONS IN ACCOMACK AND NORTHAMPTON COUNTIES BY IMPLEMENTING CDC STRATEGIES 1, 4, 5, 8, 9 AND 13. OUTCOMES: TOGETHER WITH OUR TECHNICAL ASSISTANCE PARTNERS AND COMMUNITY-BASED ORGANIZATION SUBGRANTEES, WE WILL BUILD CAPACITY TO DELIVER LOCAL DSMES, NATIONAL DPP AND CHILDHOOD OBESITY PROGRAMS THAT ARE TAILORED TO PRIORITY POPULATIONS, HAVE STRONG REFERRAL NETWORKS AND ARE ABLE TO SUSTAIN THEMSELVES. THIS WILL CONTRIBUTE TO AN INCREASED NUMBER OF PROGRAMS AND PROGRAM COMPLETERS. WE ALSO WILL INCREASE THE ABILITY OF LOCAL PRIMARY CARE PROVIDERS TO DELIVER TEAM-BASED CARE THAT ENABLES IMPROVED DIABETES SELF-MANAGEMENT, AND OF THE ENTIRE DIABETES WORKFORCE TO ADDRESS BARRIERS RELATED TO SOCIAL DETERMINANTS OF HEALTH. IN THE LONG TERM, THIS WILL RESULT IN MORE PEOPLE WITH PREDIABETES WHO REDUCE THEIR RISK OF DIABETES, CHILDREN WITH LOWER BMIS, AND FEWER PEOPLE WITH DIABETES WHO HAVE A1C LEVELS > 9%. APPROACH: EFFECTIVE PREVENTION AND TREATMENT OF DIABETES REQUIRES A TEAM-BASED APPROACH, WHETHER THAT IS IN THE CLINIC OR THROUGH CDC-FUNDED EFFORTS LIKE THIS. ACCORDINGLY, WE DESIGNED THIS PROPOSAL TO ALIGN WITH THE VIRGINIA DEPARTMENT OF HEALTH’S (VDH) COMPONENT A APPLICATION. WE DO NOT INTEND TO FOCUS ON ANY OF THE GEOGRAPHIES WHERE VDH PLANS TO PERFORM COMPONENT A-FUNDED WORK AND WE PROPOSE TO IMPLEMENT SOME STRATEGIES THAT VDH DOES NOT INTEND TO IMPLEMENT. THE GEOGRAPHIES WE SERVE CAN BENEFIT FROM THE SPREAD OF STRATEGIES THAT VDH IMPLEMENTS, SUCH AS THE HABITNU UMBRELLA HUB. THE RESULT IS EXTENDED REACH AND INCREASED IMPACT THAT MAKES SMART USE OF FEDERAL FUNDS. IN ADDITION TO ALLOCATING 30.4% OF GRANT FUNDING TO CBOS (IN YEAR 1, BUILDING TO 35.9% IN YEAR 5), WE WILL FURTHER ENGAGE COMMUNITIES BY ESTABLISHING TWO REGIONAL PATIENT AND FAMILY ADVISORY COUNCILS (PFACS) THAT WILL AMPLIFY THE VOICES OF PEOPLE IN THE PRIORITY POPULATIONS WITH PREDIABETES AND DIABETES. WE WILL CONSULT WITH THE PFACS THROUGHOUT THE GRANT TO GATHER INSIGHTS AND RECOMMENDATIONS FOR MAKING DIABETES CARE AND EDUCATION MORE ACCESSIBLE, APPROPRIATE AND FEASIBLE. WE ALSO WILL FUND TWO CBOS TO ESTABLISH A REGIONAL DIABETES COALITION OR WORKGROUP. THESE GROUPS WILL BRING TOGETHER DIABETES STAKEHOLDERS AND CBOS THAT SERVE THE PRIORITY POPULATIONS FOR COLLECTIVE ACTION TO RAISE DIABETES AWARENESS, REACH PRIORITY POPULATIONS MORE EFFECTIVELY, AND REMOVE BARRIERS CREATED BY SOCIAL DETERMINANTS OF HEALTH. CAPACITY: HQI IS A CURRENT CDC 1815 AND 1817 SUBGRANTEE TO THREE HEALTH DEPARTMENTS AND A HEALTH CARE QUALITY IMPROVEMENT ORGANIZATION WITH 39 YEARS OF EXPERIENCE. OUR PROJECT TEAM INCLUDES THE VIRGINIA CENTER FOR DIABETES PREVENTION AND EDUCATION AND THE VIRGINIA PHARMACY ASSOCIATION/VIRGINIA COMMUNITY PHARMACY ENHANCED SERVICES NETWORK.

MARYLAND PQC: REDUCING SEVERE MATERNAL MORTALITY DUE TO OBSTETRIC HEMORRHAGE - THE MARYLAND DEPARTMENT OF HEALTH (MDH) HAS SELECTED HEALTH QUALITY INNOVATORS (HQI), ITS CONTRACTOR FOR THE MARYLAND PERINATAL NEONATAL QUALITY COLLABORATIVE (MDPQC), TO APPLY FOR COMPONENT A FUNDING TO SUPPORT A QUALITY IMPROVEMENT PROJECT ON HARMFUL BLOOD LOSS RESULTING FROM CHILDBIRTH (OBSTETRIC HEMORRHAGE). HQI WILL ENGAGE THE STATE'S 32 BIRTHING HOSPITALS IN THIS WORK TO ADDRESS MARYLAND’S LEADING CAUSE OF PREGNANCY-RELATED DEATHS AND SERIOUS COMPLICATIONS (CALLED “SEVERE MATERNAL MORBIDITY.”) HQI WILL HELP HOSPITALS IMPLEMENT THE ALLIANCE FOR MATERNAL HEALTH INNOVATION (AIM) OBSTETRIC HEMORRHAGE PATIENT SAFETY BUNDLE, WHICH INCLUDES SUCH ACTIONS AS PERFORMING A HEMORRHAGE RISK ASSESSMENT AND RECORDING BLOOD LOSS FOR EVERY BIRTHING PERSON. THE AIM DATA CENTER WILL SUPPORT DATA COLLECTION AND ANALYSIS, WHICH INCLUDES PROVIDING HOSPITALS WITH REPORTS THAT SHOW WHETHER THERE ARE DIFFERENCES BETWEEN THE ASIAN, NON-HISPANIC BLACK, NON-HISPANIC WHITE AND HISPANIC POPULATIONS IN THE NUMBER OF PEOPLE WHO ARE ASSESSED FOR BLEEDING RISK AND HAVE THEIR BLOOD LOSS MEASURED. HQI WILL HELP HOSPITALS CLOSE THESE GAPS IN CARE, WHICH ARE EXPECTED TO ADDRESS THE DIFFERENCES IN MATERNAL DEATH AND COMPLICATION RATES ASSOCIATED WITH HARMFUL BLOOD LOSS. ADDITIONALLY, TO REDUCE THE HEAVY BURDEN OF OBSTETRIC HEMORRHAGE ON THE NON-HISPANIC BLACK POPULATION, HQI WILL PROVIDE A SIX-PART TRAINING WEBINAR ON RESPECTFUL CARE TO BOTH INPATIENT AND OUTPATIENT PROVIDERS (HOSPITALS, OBSTETRIC PRACTICES, FEDERALLY QUALIFIED HEALTH CENTERS, DOULAS) AND HELP THEM IMPLEMENT THE ASSOCIATION OF WOMEN'S HEALTH, OBSTETRIC AND NEONATAL NURSES' RESPECTFUL MATERNITY CARE TOOLKIT. HOSPITALS, OUTPATIENT PROVIDERS AND COMMUNITY GROUPS THAT ADVOCATE FOR MATERNAL HEALTH, PARTICULARLY FOR BLACK WOMEN, WILL ALIGN THEIR EFFORTS THROUGH FOUR REGIONAL AFFINITY GROUPS THAT FOCUS ON OBSTETRIC HEMORRHAGE AND RESPECTFUL CARE THROUGH THE LENS OF LOCAL NEEDS AND OPPORTUNITIES. ADDITI ONALLY, WE WILL STRENGTHEN MDPQC'S CAPACITY TO IMPROVE CARE FOR BIRTHING PEOPLE AND NEWBORNS BY ESTABLISHING A PATIENT AND FAMILY ADVISORY COUNCIL (PFAC) TO PROVIDE INPUT TO PROJECT PLANNING, IMPLEMENTATION AND EVALUATION.