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Process improvements and shared medical appointments for cardiovascular disease prevention in women

2013; Lippincott Williams & Wilkins; Volume: 26; Issue: 10 Linguagem: Inglês

10.1002/2327-6924.12071

2327-6886

Lisa M. Pastore, Ann Marie Rossi, Amy Tucker,

Diabetes Management and Education

Problem Cardiovascular disease (CVD) is clinically unique in women and is often underdiagnosed and undertreated. Chronic diseases account for 75% of healthcare expenditures in the United States, of which 70% are preventable through lifestyle changes and active medical management. Lifestyle modification is difficult in the context of the traditional medical visit. Design The Club Red Clinic uses a novel approach to enhance the care of women at risk for or with CVD. Through shared medical appointments (SMAs) and a multidisciplinary team approach, Club Red provides lifestyle training in addition to evidence-based practice to reduce CVD risk factors in women. In Club Red, nurse practitioners function independently and effectively in delivering lifestyle intervention for the management and prevention of CVD. Setting The clinic functions within an academic medical school at the University of Virginia. Key measures for improvement Patient access, patient satisfaction, provider efficiency, and frequency of cardiovascular visits. Effects of change Process improvements include reduced appointment wait times, improved provider efficiency (more patients seen with the SMAs), high patient satisfaction (96%), and improved adherence to recommended medical monitoring (3.8 visits/year). Lessons learned Club Red improved patient access, patient satisfaction, medical and behavioral management, and health promotion education for women with or at risk for CVD.