Using an Innovative Quality Improvement Process to Increase Delivery of Evidence-based Cardiovascular Risk Factor Care in Community Mental Health Organizations
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Diabetes Mellitus
- Sponsor
- Johns Hopkins University
- Enrollment
- 85
- Locations
- 1
- Primary Endpoint
- Quality Improvement Culture as Assessed by the Modified Version of the Validated Survey on Patient Safety
- Status
- Completed
- Last Updated
- 7 months ago
Overview
Brief Summary
This pilot study will examine whether an implementation strategy will improve delivery of evidence-based care for cardiovascular risk factors for people with serious mental illness.
Detailed Description
In this pilot study, the investigators will work with health home programs and pilot test an adapted Comprehensive Unit Safety Program (CUSP) implementation strategy to improve mental health providers' delivery of evidence-based cardiovascular risk factor care for hypertension, dyslipidemia and diabetes for individuals with serious mental illness. The project will also characterize implementation processes, organizational and provider-level factors, and cardiovascular disease risk factor care and control.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Study population 1:
- •Psychiatric rehabilitation program and health home team staff, including providers and leadership are those employed by the psychiatric rehabilitation program or health home program.
- •English-speaking.
- •Study population 2:
- •People with serious mental illness participating in psychiatric rehabilitation health home programs.
- •English-speaking
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Quality Improvement Culture as Assessed by the Modified Version of the Validated Survey on Patient Safety
Time Frame: Baseline, 12 Months
Each of the items in the modified survey is scored individually on 1-5 Likert scales. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-5. A higher average score signifies an organizational culture that is more supportive of quality improvement.
Self-efficacy as Assessed by an Adapted Version of Compeau & Higgins' Task-focused Self-efficacy Scale
Time Frame: Baseline, 12 Months
Each of the items (Hypertension, Dyslipidemia, Diabetes) are scored individually on a 1-10 Likert scale, where 1=not at all confident and 10=totally confident. An average score is calculated by summing responses across all items and dividing by the total number of items. The average score ranges from 1-10. A higher score signifies greater self-efficacy.
Secondary Outcomes
- Acceptability as Assessed by the Acceptability of Intervention Measure(Baseline, 12 Months)
- Appropriateness as Assessed by the Intervention Appropriateness Measure(Baseline, 12 Months)
- Feasibility as Assessed by the Feasibility of Intervention Measure(Baseline, 12 Months)
- Clients With Hypertension Control(Baseline and 12 Months)
- Clients With Dyslipidemia Control(Baseline and 12 Months)
- Clients With Diabetes Control(Baseline and 12 Months)
- Clients Diagnosed With Diabetes Mellitus Who Received HBA1c Measurement(Baseline and 12 Months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Lipid Panel(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received Statin Therapy(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Dilated Eye Exam(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Foot Exam(Baseline, 6 and 12 months)
- Clients Diagnosed With Dyslipidemia Who Received a Lipid Panel(Baseline and 12 Months)
- Teamwork Within Teams as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Supervisor/Manager Expectations and Actions Promoting Quality as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Organizational Learning Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Management Support for Patient Safety as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Overall Perceptions of Quality Improvement Culture as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Feedback and Communication About Error as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Communication Openness as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Frequency of Events Reported as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Teamwork Across Teams as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Staffing as Assessed by the Implementation Climate Scale(Baseline, 12 Months)
- Clients With Hypertension Who Had a Blood Pressure Measurement(Baseline and 12 Months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received a Urine-protein-creatinine Test(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Dyslipidemia Who Are on a Statin Medication(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Hypertension Who Received Lifestyle Counseling(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Diabetes Mellitus Who Received Lifestyle Counseling(Baseline, 6 and 12 months)
- Change in the Percent of Individuals Diagnosed With Dyslipidemia Who Received Lifestyle Counseling(Baseline, 6 and 12 months)