San Diego Best Practices Series: 

Right Care Initiative is currently conducting focused efforts in San Diego County to demonstrate successful, widely implementable strategies for achieving statewide heart attack and stroke prevention goals. These strategies primarily focus on lipid and blood pressure management among heart and diabetes patients. A monthly "University of Best Practices" luncheon series for medical directors of San Diego County has been designed to support clinical quality improvement efforts. 


Agendas, notes and presentations from these meetings are posted below as they become available.

January 9, 2012: Guest Speaker: Hannah Gravette, Community Lead Organizer, San Diego Organizing Project (PICO) Click for presentation: "The PICO Project"February 6, 2012: Guest Speaker: Elizabeth Oyekan, PharmD, FCSHP, CPHQ, Pharmacy Quality Medication & Patient Safety Leader, National Pharmacy Program & Services, Kaiser Permanente Click for presentation: "The BSMART Checklist: Making it easier for Providers to do the right thing as we address America's other drug problem: Medication Non Adherence"March 5, 2012: Guest Speaker: John Ovretveit, PhD, Director of Research, Professor of Health Innovation Implementation and Evaluation, Medical Management Centre The Karolinska Institute, Stockholm Click for Presentation:  "Using Research, Implementation Strategies and Innovations to Reduce Heart Attacks and Stoke and Lower Costs"

Right Care Initiative

Objective

To measurably improve clinical outcomes by enhancing the practice of patient-centered, evidence-based medicine.

  • Cardiovascular disease, with particular emphasis on hypertension
  • Diabetes, with particular emphasis on heart attack and stroke prevention
  • Hospital acquired infections
  • Data from NCQA, The Integrated Health Care Association, the Agency for Health Care Quality and Research, the Commonwealth Foundation, the Centers for Disease Control indicate three trouble spots where evidence‐based clinical quality improvement will significantly enhance and save lives.

    With an expert-based, public-private, multi-year collaborative, the Right Care Initiative focuses on:


    View a printable version of the Right Care Initiative Project Brief

    Thanks to an NIH GO grant, the Right Care Initiative and its partners have initiated a community focused effort in San Diego centered on the Right Care goals of preventing heart attacks, strokes, and diabetes related complications. This grant provides a special opportunity to launch intensive efforts toward achieving the national 90th percentile of HEDIS performance in hypertension, cardiovascular disease, and diabetes prevention. For more information, view the statistical brief, the San Diego: Preventing Heart Attacks, Strokes and Diabetes-Related Complications.

    View a presentation on the California Right Care Initiative given by Robert Kaplan, PhD: http://videocast.nih.gov/summary.asp?live=10001&debug=0.  Dr. Kaplan formerly led the Right Care Initiative as its NIH GO Grant Principal Investigator. He is currently the NIH Office of Behavioral and Social Sciences Research (OBSSR) Director.

    Promising Interventions to Reach HEDIS Control Targets for Heart Attack and Stroke Prevention

    Project Inspiration

    NCQA estimates that improving the cardiovascular disease and diabetes measures among California’s 15 million commercial managed health plan enrollees to the national HEDIS 90th percentile could result in 1,694 to 2,818 Californian lives saved annually. It would also avoid $118 million in yearly hospital costs, 766,401 sick days and $125.56 million in lost productivity. Hospital acquired infections are estimated to kill more than 10,000 Californians per year, and are mostly preventable.

    Heart disease, hypertension, diabetes, and prevention of hospital acquired infections are increasingly well understood scientifically. Like the “100,000 Lives” national campaign for reducing medical errors, this project will improve the lives of tens of thousands of California enrollees by catalyzing the work of experts and applying evidence based medicine in the coordinated, managed care model.

    Implementation Action and Goals

    Through periodic meetings, research, quality improvement support for medical groups, and collaborative action, the statewide goal of the Right Care Initiative is to reach the 90th percentile in heart and diabetes HEDIS control measures of blood pressure, lipids, and glucose, and to cut the rate of death from hospital acquired infections.

    Four summits have been held since March 2008—the first annual Clinical Quality Improvement Leadership Summit—when DMHC launched the Right Care Initiative jointly with NCQA and the Deans of UCLA and UC Berkeley Schools of Public Health. Each Right Care gathering is a collaborative effort with the community, leading health plan and medical group medical directors, as well as thought leaders in evidence-based medicine. For more information from past Right Care meetings, including agendas and selected slideshows, view Meeting Agendas, Presentations & Notes.
    topResearch Questions

    • What are the most promising interventions for quickly bringing patients into safe control?
    • What barriers are preventing improvement, and what are the best strategies for overcoming them?
    • What are the best strategies for California to expedite a focused re-engineering effort to refine the implementation of evidence-based medicine to quickly meet these goals that are estimated to save thousands of lives annually?
    • What strategies are needed to improve clinical outcomes in light of health disparities in California’s diverse population?
    Contact: Hattie Rees Hanley, MPP, Right Care Initiative Project Director, hattiehanley@post.harvard.edu, (916) 323-2704
    State-Wide Right Care Technical Expert Steering Committee Chair, and Vice Chair, and Founding Principal Investigator:
    Stephen Shortell, PhD, MPH, Professor and Dean, University of California, Berkeley, School of Public Health

    Carol Mangione, MD, MSPH, Professor of Medicine and Public Health, UCLA Schools of Public Health & Medicine

    Robert Kaplan, PhD, Director , Office of Behavioral and Social Sciences Research (OBSSR), NIH
    San Diego Demonstration Project Steering Committee Chair and Co-Vice Chairs:
    Anthony DeMaria, MD, Chair, Judith and Jack White Chair in Cardiology and Director, UCSD Sulpizio Family Cardiovascular Center; Editor-in-Chief, Journal of American College of Cardiology

    Judith and Jack White, Co-Chairs; San Diego Heart Attack and Stroke Prevention Champions

    Jim Dudl, MD, First Vice-Chair, Clinical Lead, Care Management Institute, Kaiser Permanente and practicing endocrinologist

    James Dunford, MD, Second Vice-Chair, City of San Diego Medical Director; President of the Board of the Greater San Diego American Heart Association
    Cardiovascular Disease and Diabetes Principal Investigators
    Carol Mangione, MD, MSPH, Professor of Medicine and Public Health, UCLA Schools of Public Health & Medicine

    Allen Fremont, MD, PhD, RAND, Director, Action Consortium to Accelerate Change, Practicing Physician, Department of Veterans Affairs
    Hospital Acquired Infections (HAI) Principal Investigators
    Helen Halpin, PhD, Professor and Director, Center for Health and Public Policy Studies, UC Berkeley School of Public Health

    Arnold Milstein, MD, Medical Director, Pacific Business Group on Health; National Health Care Thought Leader, Mercer; Director, Stanford Clinical Excellence Research Center
    Funding


    This project has been made possible by the generosity of the following supporters: Judith and Jack White, Johnson & Johnson, the National Heart, Lung and Blood Institute (National Institutes of Health), the California Office of the Patient Advocate, Blue Shield of California Foundation (HAI), California Health Care Foundation (“hot spot” identification), Novartis, and Sanofi Pasteur. This funding enables UC, RAND, and the California Chronic Care Coalition to provide external support for meeting the Right Care Initiative goals.