KENTUCKY REGIONAL EXTENSION CENTER

Payers are increasingly measuring and paying health care providers differently based on performance on quality, cost and outcome measures. The Kentucky REC has quality improvement experts trained in LEAN methodologies, patient experience of care and the Model for Improvement who can assist practices and hospitals with improving care for their patients.

Under two funded projects with the Kentucky Dept. for Public Health, the Kentucky REC is helping practices develop quality improvement plans related to hypertension, diabetes A1c control, and colorectal cancer screening.

Organized Approaches to Increased Colorectal Cancer (CRC) Screening

The Kentucky Department for Public Health and a group of partners including the Kentucky Regional Extension Center were awarded a five-year grant from Centers for Disease Control called  “Organized Approaches to Increased Colorectal Cancer (CRC) Screening.” The target population for this grant are aged 50-75, asymptomatic, average CRC risk patients and low-income residents of Louisville or Appalachia. Goal of the grant is to increase CRC screening rates in the target population.

Partners on this grant include:

• American Cancer Society
• Kentucky Primary Care Association
• Kentuckiana Health Collaborative
• Kentucky Cancer Consortium
• Kentucky Cancer Program
• Colon Cancer Prevention Project
• Department for Medicaid Services

The work in this grant focuses on Priority Evidence-Based Interventions (EBIs) including Provider Assessment and Feedback, Provider Reminders, Patient Reminders and Reducing Structural barriers. Secondary EBIs and supporting strategies include use of small media, professional development and training, health information technology, patient navigation and community clinical linkages. We are currently in Year 3 of the grant and we working with four FQHC in Kentucky to increase their CRC rates.

DPH-REC Chronic Disease Pilot

The Kentucky Regional Extension Center and the Kentucky Department for Public Health (DPH) Chronic Disease Branch are working together on a CDC-funded pilot project focusing on Hypertension and Diabetes improvement. The specific measures covered in the grant are Controlling High Blood Pressure (NQF 0018) Percentage of patients 18 – 85 with adequately controlled hypertension (blood pressure < 140/90) and Diabetes: Hemoglobin A1c Poor Control (NQF 0059) Percentage of patients 18 – 75 with hemoglobin A1c > 9.0%. We are currently in Year 3 of the pilot project, working with six practices across Kentucky.

Since February 2016 the Practice Advisors of KY REC have used education, quality reporting, EHR optimization and quality improvement strategies to work with practices on improving rates of control for high blood pressure and hemoglobin A1C. We continue to monitor rates monthly and encourage each practice to use Plan-Do-Study-Act Cycle (PDSA) to conduct small tests of change within each practice.