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Evaluating a Statewide Health System Improvement Effort: Reducing Time to Treatment for Heart Attack and Stroke Patients
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| Presenter(s):
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| Megan Mikkelsen, Washington State Department of Health, megan.mikkelsen@doh.wa.gov
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| Abstract:
The Centers for Disease Control and Prevention(CDC) funded Emergency Cardiac and Stroke Technical Advisory Committee (TAC), brings statewide stakeholders together to establish a coordinated emergency response system that improves the quality of care for heart attack and stroke patients in Washington State. The evaluation follows the CDC framework for evaluation and measures short and long term outcomes that should lead to better emergency response and hospital care for individuals having a heart attack or stroke. The evaluation of this program includes a variety of methods and sources to determine success. Process measures focus on stakeholder awareness and support of the work of the TAC, adoption of the emergency medical service (EMS) and hospital protocols recommended by the TAC, and statewide trainings. Measurement of EMS and hospital use of guidelines created by the TAC demonstrates success in pushing the time to treatment and quality of care goal.
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Assuring Quality in the Design of a Multi-state Surveillance Evaluation
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| Presenter(s):
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| Monica Oliver, Centers for Disease Control and Prevention, ior3@cdc.gov
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| Rachel Barron-Simpson, Centers for Disease Control and Prevention, rbarronsimpson@cdc.gov
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| Abstract:
From 2005-2007, the Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention funded four states to develop and implement a state cardiovascular health examination (CVHSE) survey. The CVHSE survey project combines the use of patient interviews and health examinations to facilitate the collection of state-level cholesterol and blood pressure data. This presentation describes the process-and-outcome evaluation undertaken to understand the implementation challenges and opportunities of the CVHSE survey. It discusses how the breadth of expertise and perspectives on the evaluation team, in tandem with focused pre-evaluation interviews with pilot states, provided quality assurance for the design of the full evaluation. Ernest House describes ‘beauty’ in evaluation quality as involving, among other things, authenticity and form; the results of the CVHSE survey evaluation demonstrate that the contextual elements of each pilot case have informed ‘beauty’ for future iterations of the CVHSE survey.
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Outcome Measurement in Health Evaluation: Evaluation of the Heart & Stroke Foundation of Ontario’s (HSFO) Hypertension Management Initiative (HMI)
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| Presenter(s):
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| Shirley Von Sychowski, Heart and Stroke Foundation of Ontario, svonsychowski@hsf.on.ca
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| Abstract:
In this paper, we describe the use of a prospective delayed design to evaluate the HMI and to assess its impact independent of community trends, as well as high-level results HMI has yielded after 3 years in field.
The HMI is an inter-professional chronic disease management program in 11 communities across Ontario aimed to improve the management and control of hypertension. Hypertension, a major risk factor for cardiovascular mortality, is ranked as the highest diagnostic category for drug expenditures in Canada. Interventions can make a difference if significant change is achieved in blood pressure (BP) control: clinical trials demonstrate that a 3 mmHg reduction in BP leads to 8% reduction in mortality due to stroke, 5% reduction in mortality due to coronary heart disease, and 4% decrease in all-cause mortality.
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Evaluation at the Community Level: The Importance of Quality
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| Presenter(s):
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| Aisha Tucker Brown, Northrop Grumman Corporation, atuckerbrown@cdc.gov
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| Alberta Mirambeau, Centers for Disease Control and Prevention, amirambeau@cdc.gov
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| Abstract:
The Division for Heart Disease and Stroke Prevention (DHDSP) supports its grantees in conducting quality evaluation at the state and local level. It is imperative that evaluations conducted at the community level be of good quality and address effectiveness and accountability. Thus, the division provides grantees with tools and technical assistance to produce quality evaluation results. Specifically, DHDSP provides evaluation leadership and support to the Mississippi Delta, an area with a particularly high burden of heart disease and stroke. DHDSP’s support includes aiding in the development of strategies to evaluate program initiatives and providing ongoing evaluation consultation and expert advice to program staff and their mini-grantees in the Delta Region in an effort to build evaluation capacity and ensure quality evaluations are being conducted at the community level. This presentation will focus on the quality of the evaluation work of two Mississippi Delta community level projects.
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