An interprofessional model of care supporting the million hearts initiative

Background: Evaluation of Pierce County and Washington state death rates found that cardiovascular disease is the leading cause of death. We hope to improve patient outcomes by promoting educational programs and developing an interprofessional health care team. Objective: We aim to develop, implement, and evaluate a cardiovascular disease risk reduction program in a community clinic setting. The goals include: To 1)promote strategies aimed at reducing the risk of cardiovascular events, such as heart attack and stroke, 2)educate on healthy living choices, and 3)increase accessibility to health care services with a focus on low-income patients. Methods: The project used a multi-tiered approach based on the patients' level of need and severity of disease. The first tier involved developing health fairs around the Pierce County neighborhoods to promote accessibility to health care. Educational materials and health screenings were offered to promote health awareness. The 2nd tier consisted of student led educational seminars in cardiovascular related issues such as diabetes management and nutrition. These were open to the public and focused on cardiovascular education and understanding risk factors. The 3rd tier was reserved for patients at highest risk of cardiovascular disease. Patients were assigned one student and preceptor to meet periodically throughout the year to re-evaluate therapeutic goals and adherence. Services included patient education, medication use, adoption of healthy lifestyle habits, and development of a patient-centered action plan. Changes in blood pressure, A1C, lipid levels, medication adherence, and follow-up exam results were tracked. Data and findings will be presented during the final presentation.