Dr. Uma Krishnan represented the Prevention Center of Excellence in their LDL process improvement work with a poster presentation at the local American College of Cardiology (ACC) chapter in September. The Prevention COE was awarded second place overall. This work was also accepted as an ePoster for the ACC Quality Summit in Florida in October.
The Prevention COE’s work to lower LDL to less than or equal to 70 is led by Uma Krishnan MD; L. Doug Waggoner MD; Pam Kozu RN, MN; and Shelley McCabe CEP, FAACVPR. Shane Dayton and the Health Catalyst team provided critical assistance in configuring Power BI and additional data in support of this project over several years. To be asked to present this work is a huge honor and highlights the great work Pulse is doing.
The program
The Prevention Center of Excellence looked at the cardiology practice outcomes in 2019 and found only 29% of patients with the highest risk had LDL ≤ 70. While nationally, according to Pinnacle registry, the average was 32%, highlighting suboptimal levels of lipid lowering therapy in our clinical practice. The team looked at barriers and found the following 3 areas were the highest contributors: lack of standardized workflow, patient adherence, and medication prior authorization.
The team proposed to optimize lipid-lowering therapy for those patients with established ASCVD to meet secondary prevention goal, improve clinical outcomes, and reduce cost and hospitalizations by developing a standardized pathway utilizing current staff while enhancing the RN role to adjust the statin to meet the ACC guideline of LDL ≤ 70. There were many steps, trials and redirections along the way.
Overall, in the past 2 years since initiating the first pathway, there has been a 22% improvement in LDL ≤ 70 compliance in the highest-risk patients. Future direction will focus on improving patient compliance and engagement by analyzing and acting on Population Health data to achieve value-based care goals; improve patient experience and outcomes by delivering comprehensive, coordinated, and effective care at a lower cost.
For more information about Pulse Heart Institute and its programs, visit the Pulse website or call:
Inland Northwest 509-755-5500
Puget Sound Region 253-572-7320