Implementation of Routine Cardiovascular Risk Scoring and Patient Education in Primary Care: A Quality Improvement Project
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Authors
Rowell, Jessica
Issue Date
2023-04-25
Volume
Issue
Type
Manuscript
Language
Keywords
ASCVD , Cardiovascular Disease , Screening
Alternative Title
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death for all genders and most ethnicities in the United States. Providers are urged to utilize research-based approaches toward enhancing health outcomes and integrate strategies aimed at reducing disease risk. The purpose of this project was to improve the current use of ASCVD stratification tools, enhance risk documentation within medical records, and to streamline patient education and shared decision-making processes. The population included providers in an urban Midwest primary care office, who were given information regarding the project plan and subsequently coached screen all qualified patients for 10-year and lifetime ASCVD risk. Providers integrated appropriate objective data, including modifiable and non-modifiable factors as per the ACC/AHA guidelines for ASCVD risk stratification using a risk calculator tool. Data compiled were assessed for frequency of risk stratification, documentation of score, regularity of patient education, and rate of shared decision-making. A three-phase quality improvement project with emphasis on provider education was carried out to determine baseline, intervention, and post-intervention implementation and documentation of risk, as well as use of streamlined patient education and shared decision making. Baseline results determined that processes were not standardized for either risk stratification or patient education. Following education, providers more frequently utilized the EPIC embedded risk calculator (60%), as well as incorporated the EPIC After Visit Summary education worksheets (92%) for lifestyle changes based on patient’s risk at the conclusion of each surveyed annual wellness visit. The post-intervention phase demonstrated a slight drop in all of the measured tasks, which indicates continual need for provider counseling, support, and an ongoing assessment of limitations that create barriers to following the ACC/AHA guidelines for cardiovascular screening.
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Citation
Publisher
Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University