Article Figures & Data
Figures
- Figure 1.
Conceptual model for EvidenceNOW Southwest intervention.
- Figure 2.
Consolidated Standards of Reporting Trials (CONSORT) practice engagement diagram.
Tables
- Table 1.
EvidenceNow Southwest Transformation Support Interventions for Standard and Enhanced Arm Practices
Program Element Standard Practice Support Enhanced with Patient Engagement Practice assessment with feedback to practice Yes Yes Practice facilitation with monthly improvement team meetings Yes Yes Collaborative learning sessions Yes Yes Health Information Technology support Yes Yes Cardiovascular toolkit, including e-learning modules Yes Yes Patient engagement materials from boot camp translation No Yes Support for Patient and Family Advisory Councils No Yes Characteristic Mean (SD) or % of: Standard vs Enhanced P Value Total (N = 211) Standard (N = 129) Enhanced (N = 82) State Colorado 74.9% 69.8% 82.9% .032 New Mexico 25.1% 30.2% 17.1% Ownership Clinician 47.9% 32.6% 72.0% Hospital/academic center 15.6% 14.7% 17.1% <.001 Federally Qualified Health Centers 36.5% 52.7% 11.0% Rural 28.9% 37.2% 15.9% .001 Patient-Centered Medical Home 44.6% 55.8% 26.8% <.001 Practice size, number of providers Solo 21.0% 24.2% 16.1% 2–5 60.5% 60.5% 60.5% .348 6–10 16.6% 13.7% 21.0% >10 2.0% 1.6% 2.5% Payer mix % Medicaid 27.4 (22.1) 31.8 (20.5) 19.9 (22.9) <.001 % Medicare 18.7 (14.0) 18.7 (13.2) 18.8 (15.4) .988 % No insurance 11.2 (13.9) 12.3 (13.1) 9.2 (15.0) .142 % Commercial insurance 37.6 (25.2) 32.5 (22.3) 46.0 (27.7) <.001 Demographics Race % Black 3.5 (5.6) 2.9 (5.7) 4.5 (5.5) .054 % Asian 2.6 (6.3) 2.2 (5.2) 3.2 (7.7) .322 % Alaskan Native/American Indian 3.6 (13.6) 5.0 (17.1) 1.2 (2.7) .021 Ethnicity % Hispanic 29.4 (25.0) 34.7 (26.1) 20.6 (20.5) <.001 Gender % Female 54.2 (9.3) 53.6 (10.0) 55.1 (8.0) .277 Patient registries Any registry 67.8% 70.5% 63.4% .280 Ischemic vascular disease 37.9% 42.6% 30.5% .076 Hypertension 54.0% 59.7% 45.1% .039 High cholesterol 44.6% 52.7% 31.7% .003 Diabetes 64.0% 65.9% 61.0% .468 Prevention services 53.6% 62.8% 39.0% .001 High risk or utilization patients 35.1% 38.0% 30.5% .266 Use of clinical guidelines Prevention Number of guidelines 1.8 (1.4) 1.9 (1.4) 1.7 (1.3) .276 No guidelines used 16.6% 16.3% 17.1% .880 Informal (agreed or posted) 62.1% 58.1% 68.3% .138 Standing orders 33.7% 38.8% 25.6% .049 Electronic health record prompts 59.7% 62.0% 56.1% .393 Management Number of guidelines 1.7 (1.4) 1.8 (1.4) 1.6 (1.3) .354 No guidelines used 18.5% 18.6% 18.3% .955 Informal (agreed or posted) 59.7% 56.6% 64.6% .246 Standing orders 29.9% 34.1% 23.2% .091 Electronic health record prompts 56.4% 58.1% 53.7% .522 SD, standard deviation.
Variable Adjusted OR (95% CI) for: Aspirin Use (N = 179) Blood Pressure (N = 189) Cholesterol (N = 90) Smoking (N = 183) Time (change per quarter in standard arm) 1.03 (1.01, 1.05) 1.02 (1.00, 1.04) 1.07 (1.04, 1.09) 1.03 (0.99, 1.06) Baseline differences (enhanced vs standard) 0.85 (0.59, 1.22) 1.03 (0.78, 1.36) 1.07 (0.80, 1.43) 0.79 (0.44, 1.44) Clinician-owned (ref) Hospital Owned 2.85 (1.83, 4.44) 0.62 (0.44, 0.88) 1.18 (0.88, 1.57) 0.50 (0.24, 1.02) Federally Qualified Health Center 1.62 (1.12, 2.34) 0.94 (0.71, 1.26) 0.84 (0.63, 1.15) 2.37 (1.28, 4.41) Time by intervention 1.03 (0.99, 1.06) 0.98 (0.95, 1.01) 0.96 (0.92, 1.00) 1.01 (0.96, 1.07) CI, confidence interval; OR, odds ratio.
- Table 4.
ABCS Clinical Quality Measures: Practice Estimate Comparisons between Combined Study Arms and External Controls
Measure ENSW Practices (Est [95% CI]) External Controls (Est [95% CI]) P Value for Difference in Slopes Baseline 12 Months Baseline 12 Months Aspirin 0.668 (0.628, 0.705) 0.763 (0.722, 0.799) 0.049 (0.039, 0.061) 0.049 (0.036, 0.068) .012 Blood Pressure 0.606 (0.572, 0.639) 0.618 (0.585, 0.650) 0.441 (0.402, 0.481) 0.429 (0.392, 0.467) .040 Smoking 0.826 (0.794, 0.854) 0.843 (0.814, 0.868) 0.167 (0.138, 0.201) 0.144 (0.120, 0.177) <.001 Cholesterol 0.659 (0.628, 0.689) 0.704 (0.675, 0.730) 0.511 (0.481, 0.540) 0.494 (0.465, 0.423) <.001 Est, estimate; ENSW, EvidenceNOW Southwest; CI, confidence interval.
Building Block Term Standard Estimate* (SE) Enhanced Estimate* (SE) Comparison and P Value Leadership Baseline 51.9 (2.1) 56.5 (2.7) Overall improvement, <.001 Follow-up 82.2 (2.1) 87.8 (2.8) Time × arm, .783 Data-Driven Improvement Baseline 38.2 (2.2) 38.5 (2.8) Overall improvement, <.001 Follow-up 76.2 (2.2) 80.4 (2.9) Time × arm, .327 Empanelment Baseline 60.0 (3.5) 49.5 (4.6) Overall improvement, .202 Follow-up 55.9 (3.6) 55.6 (4.7) Time × arm, .052 Team-Based Care Baseline 49.4 (2.6) 48.8 (3.3) Overall improvement, <.001 Follow-up 65.3 (2.6) 72.2 (3.4) Time × arm, .043 Patient-Team Partnership Baseline 30.81 (1.8) 27.7 (2.3) Overall improvement, <.001 Follow-up 44.4 (1.8) 46.3 (2.3) Time × arm, .011 Population Management Baseline 40.3 (2.4) 40.3 (3.2) Overall improvement, <.001 Follow-up 60.5 (2.5) 63.6 (3.3) Time × arm, .033 ↵* Adjusted for practice ownership and rural location.
In this issue
Jump to section
Related Articles
Cited By...
- Successful Implementation of Integrated Behavioral Health
- What AHRQ Learned While Working to Transform Primary Care
- Estimating the Cardiovascular Disease Risk Reduction of a Quality Improvement Initiative in Primary Care: Findings from EvidenceNOW
- Estimating the Cardiovascular Disease Risk Reduction of a Quality Improvement Initiative in Primary Care: Findings from EvidenceNOW
- An Assessment of Weight Loss Management in Health System Primary Care Practices
- How Does Prior Experience Pay Off in Large-Scale Quality Improvement Initiatives?
- The EvidenceNOW Practice Support Initiative: The Heart of Virginia Healthcare
- How Does Prior Experience Pay Off in Large-Scale Quality Improvement Initiatives?
- The Changing Face of Primary Care Research and Practice-Based Research Networks (PBRNs) in Light of the COVID-19 Pandemic