Cardiovascular Disease Is Focus of New AAFP Performance Improvement CME Program

$1 Million GSK Grant Will Fund Inaugural Healthy Communities Collaborative

December 06, 2010 05:20 pm News Staff

Early next year, the AAFP will start rolling out a new performance improvement CME program that will help family physicians enhance the comprehensive care they provide to patients with cardiovascular disease, or CVD. Called the AAFP Healthy Communities Collaborative, or HCC, the Academy is launching the 18-month longitudinal curriculum in collaboration with its Wisconsin and Indiana chapters.

The inaugural AAFP HCC, which is built on the Academy's existing performance improvement CME programs -- Measuring, Evaluating and Translating Research Into Care, or METRIC, and the Quality Improvement Practice Enhancement Forum, or PEF -- will help 32 family medicine practice teams in Wisconsin and Indiana achieve practice-based improvements aimed at improving cardiovascular care.

The program is being funded through a $1 million grant from the GlaxoSmithKline, or GSK, Center for Medical Education. The Academy is one of only 20 select CME providers that GSK has said it will continue to support under new criteria announced last year. Of those 20 selected providers, only four, including the AAFP, were awarded grants in the current funding cycle.

Bill Sigmund, M.D., senior vice president of North American Medical Affairs at GSK, said the company is supporting the AAFP program because it is a high-quality initiative that can improve patient health.

"The project includes measurement of patient and practice level data to determine the extent to which the interventions improved patient care," Sigmund said in a prepared statement. "This is an important and specific way that grants such as this can address the medical burden posed by cardiovascular disease."

Integrating Performance Improvement and Outcomes Assessment

According to an executive summary of the program, the AAFP HCC "integrates current best practices in QI (quality improvement), PI (performance improvement) CME and research evaluation to help participants achieve measurable, sustainable improvements in addressing learning needs and practice performance gaps when caring for patients with CVD and related health risk factors and comorbidities."

The program's learning objectives note that family physicians who participate in the AAFP HCC will be better able to

  • provide leadership to help their practices cooperate, collaborate, communicate and integrate care in teams to ensure that care for patients with CVD is continuous and reliable;
  • apply quality improvement to understand and measure quality of care in terms of structure, process and outcomes in relation to patient and community needs, as well as design and test interventions to change processes and systems of care;
  • provide patient-centered care and communication and counsel patients on how to reduce their risk of developing CVD and how to manage related conditions; and
  • conduct appropriate screenings on patients with coronary artery disease, or CAD, such as serum cholesterol tests, blood pressure and weight measurement, and provide recommended treatments, such as antiplatelet therapy.

The program will use clinical performance measurement sets developed by the AMA Physician Consortium for Performance Improvement and endorsed by the nonprofit National Committee for Quality Assurance.

The planning and development phase will launch in January with recruitment of physician champions and program coordinators and meetings with program faculty and state chapter leaders. Practice teams and QI coaches are scheduled to be recruited beginning in February.

Breakdown of Program Components

The AAFP HCC program includes a number of components. Using physician champions and QI coaches, the practice teams will complete baseline practice and patient data assessment activities, including

  • the retrieval of patient medical record data using the Physician Consortium for Performance Improvement clinical measures;
  • completion of a clinician staff questionnaire to assess practices' ability to change; and
  • an assessment of levels of implementation of components of the Chronic Care Model, which was developed by the MacColl Institute for Healthcare Innovation.

The practice teams then will participate in a two-day PEF workshop featuring face-to-face, interactive, team-based learning sessions emphasizing practice redesign and improvement, as well as leadership, team development and change management skills.

Following the workshop, teams will obtain additional education through participation in various performance improvement projects; monthly Web-based learning sessions; online CME; and an online community in which they can share their successes, challenges and resources.

The practice teams will test and implement interventions, such as integrating clinical decision support, engaging patients in self-management, and incorporating patient registry functionality to identify and engage patients with CAD. They also will monitor patient outcomes, recall patients for recommended treatment and provide appropriate follow-up.

At the end of the program, teams will re-measure their patient and practice data to assess the extent to which interventions improved patient care. In addition, the AAFP National Research Network will conduct an independent evaluation to gauge whether learning objectives were met and outcomes were achieved in regard to the teams' clinical knowledge, performance measures and patient health outcomes.

Findings will be submitted for publication in peer-reviewed medical and educational journals and also will be presented at medical and educational conferences.

When they have completed the core components of the AAFP HCC program, family physicians will be eligible to earn as many as 40 AAFP Prescribed CME credits. They also will fulfill Part IV of the Maintenance of Certification requirements of the American Board of Family Medicine via completion of the AAFP's METRIC module on CAD.