Million Hearts. Overview and Implications for Surveillance and Quality Improvement. Heart disease and stroke are leading killers in the U.S. Cause 1 of every 3 deaths >2M heart attacks and strokes/year, 800,000 die
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Overview and Implications for Surveillance and Quality Improvement
Hearts at Risk:
>100M U.S. adults smoke, have uncontrolled high blood pressure, or uncontrolled high cholesterol
Bars = number
Line = percent
Source: MMWR: Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Disease Risk Factors─United States, 2011, Early Release, Vol. 60
Improved cardiovascular care could save 100,000 lives/year in U.S.
Number of deaths prevented
Percent eligible using service
Source: Farley TA, et al. Am J Prev Med 2010;38:600-9.
Source: MMWR: Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Disease Risk Factors — United States, 2011, Early Release, Vol. 60.
1 Population-wide indicators
2 Clinical systems
Other Supporting Activities:
Community prevention addressing nutrition, physical activity, obesity reduction, and other issues
Early recognition and
effective treatment of acute events
Primary Targets of Change
Na, ATF, Smoking
Other health care
…reducing the need for treatment
…improving quality, access and outcomes
Initial Visit (attn to ABCS)
Between ABCS Visits
Follow Up ABCS Visit
Patient candidate for ABCs attention?
Discuss risk factor(s) & mgmt
Understand & adhere to mgmt plan
(adherence & concerns)
Refine mgmt plan
Follow up on tests
Patient specific education, reminders, clinical data
Pre-visit questionnaires, relevant data presentation
EBM best practice recs
ABCS Data (flowsheet, alert);
Patient info on risks & mgmt strategies
Patient specific orders, recs, referrals, education
Relevant lab data/alerting
Identify high risk patients (ABCS) using reports from registry