Dr. Hadii Mamudu, Professor in the East Tennessee State University College of Public Health Department of Health Services Management and Policy is co-author of an article in The Joint Commission Journal on Quality and Patient Safety. The article is titled Building Statewide Quality Improvement Capacity to Improve Cardiovascular Care and Health Equity: Lessons from the Tennessee Heart Health Network.
Lead author is Dr. Cori Grant of the University of Tennessee Health Science Center. Additional co—authors include faculty from the University of Memphis and the University of Tennessee Health Science Center.
The driving forces behind this research include the fact that many states with high rates of cardiovascular disease lack statewide quality improvement infrastructure (for example, resources, leadership, community) to address relevant health needs of the population. Academic health centers are well positioned to play a central role in addressing this deficiency. This article describes early experience and lessons learned in building statewide QI infrastructure through the Tennessee Heart Health Network.
A statewide, multistakeholder network composed of primary care practices, health systems, health plans, quality improvement organizations, patients, and academic institutions was led by the University of Tennessee Health Science Center, an academic health center, to improve cardiovascular health by supporting dissemination and implementation of patient-centered outcomes research evidence-based interventions in primary care. Primary care practices were required to select and implement at least one of three interventions (health coaching, tailored health-related text messaging, and pharmacist-physician collaboration).
Thirty statewide organizational partners joined the Network in year one, including 18 health systems representing 77 primary care practices (30.0% of 257 potentially eligible practices identified) with approximately 300,000 patients. The organizational partners share electronic health records for the ongoing tracking and reporting of key health metrics, including hypertension control and delivery of tobacco cessation counseling. Of the 77 practices, 62 continue participation after year two (80.5% retention).
Main barriers to participation and reasons for discontinuing participation included reluctance to share data and changes in leadership at the health system level. These 62 PCPs selected the following interventions to implement: health coaching (41.9%), tailored health-related text messages (48.4%), and pharmacist-physician collaboration (40.3%).
Academic health centers have broad reach and high acceptability by diverse stakeholders. Tennessee's experience illustrates how academic health centers can serve as platforms for building a statewide infrastructure for disseminating, implementing, and sustaining QI interventions at the practice level. Assessment of Network impact is ongoing.