Programs and Initiatives in Health Care – Quality Improvement

Programs & Initiatives in Health Care
Practice Facilitation
Healthy Northland Million Hearts® Initiative

Healthy Northland, a collaboration between Carlton-Cook-Lake-St. Louis Community Health Board (CHB) and Aitkin-Itasca-Koochiching Community Health Board, implemented a Million Hearts® project to enhance clinics’ ability to identify and manage patients with hypertension using a team-based approach.

Onboarding clinics

The collaboration initially approached clinics who they already were working with. Four clinics of those clinics immediately agreed to work with them on this project. In order to bring additional clinics on board, the collaborative began recruitment through mail, phone calls and in-person meetings. Those meetings were facilitated by regional public health personnel, a registered nurse and a physician, who had experience in health care field.

During the project period, Healthy Northland staff met monthly with their clinic grant teams through webinars and face-to-face trainings, forming a learning collaborative and strengthening the relationship between local public health and the participating clinics.

Connecting to healthy communities

The project staff also met with local county public health directors and Statewide Health Improvement Program (SHIP) coordinators to learn about their communities efforts to promote active living, healthy eating, tobacco cessation, evidence based self-management programs and other chronic disease prevention efforts.

During clinic practice facilitation meetings, the SHIP coordinator and/or public health director would share public health’s community-based, chronic disease prevention activities, and offer suggestions on how clinic providers could refer or make patients aware of these opportunities.

The partnership mirrored existing public health and clinic relationships that were already focusing on prevention like Child and Teen Checkups.

Sharing best practices

The project staff shared hypertension-related resources around quality improvement including sample protocols and policies, online toolkits, as well as case studies of hypertension control projects led by a variety of organizations.

They also worked with MDH to secure speakers for their learning collaborative, using local and regional professionals with experience in team-based care, hypertension control quality improvement in clinics, and use of health information technology. In addition, there was dedicated time for clinics to share their own learnings with each other.

Using a team-based care approach, the clinics worked on three main evidence-based strategies from the Guide to Community Preventive Services: accurate measurement of blood pressure, adopting a hypertension treatment protocol with clinical decision supports, and implementing a home blood pressure monitoring program. They used evidence based guidelines and sample protocols from the Institute for Clinical Systems Improvement, Community Guide to Preventive Services, CDC, Million Hearts, as well as others.

Expanding practice facilitation

Healthy Northland continues offering practice facilitation to primary care clinics to improve the quality of care for hypertension, obesity, prediabetes and tobacco cessation. They focus on improving referral and communication to and between evidence based self-management programs, and promoting team-based care to strengthen links between clinic systems, and community-based programs and activities.