Stage of Change 6: Execute and Measure Your Impact
Table of Contents
- Educate practice staff on CKD assessment and management.
- Engage practice staff in the refinement and application of the implementation strategy in their own workflows
- Utilize electronic health record and claims data to illustrate CKD care among patients with hypertension and/or diabetes in the care team's patient panel.
- Ensure the care team receives ongoing feedback about the agreed upon CKD interventions/quality metrics.
- References
Periodic assessment of interventions and implementation strategies are an integral part of a CKD care improvement plan. The following educational resources and measurement tools can support assessment of care team activities.
Educate practice staff on CKD assessment and management.
Resources and Tools:
- NKF, Management Algorithm: How to Manage your CKD Patients, a tool that facilitates management of patients with or at risk for CKD.
- Island Peer Review Organization (IPRO), Chronic Kidney Disease (CKD) Screening and Management Mobile Apps, includes Clinician Screening app for earlier CKD identification and management to help delay progression.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Kidney Disease for Health Professionals, clinical practice tools assist health care professionals in diagnosing and treating patients with kidney disease.
- Agency for Healthcare Research and Quality (AHRQ), Create and Support High Functioning Care Teams to Deliver High-Quality Evidence-Based Care, tools and resources to optimize care team performance.
- Agency for Healthcare Research and Quality (AHRQ), Tools and Resources for Practice Transformation and Quality Improvement, tools and resources for care team members to employ in a quality improvement activity.
- Centers for Disease Control (CDC), Vital Signs: Decrease in Incidence of Diabetes-Related End-Stage Renal Disease among American Indians/Alaska Natives–United States, 1996–2013, a report on the positive impact of public health and population management approaches to improved clinical care and outcomes.(77)
Engage practice staff in the refinement and application of the implementation strategy in their own workflows
Resources and Tools:
- Public Health, 2019, Implementation Mapping: Using Intervention Mapping to Develop Implementation Strategies, application of implementation mapping as a systematic process to develop strategies to improve adoption, implementation, and maintenance of evidence-based interventions.(78)
RE-AIM (Reach, Effectiveness, Adopt, Implement, Maintain)
Resources and Tools:
- RE-AIM (Reach-Effectiveness-Adoption-Implementation-Maintenance), 2019, Resources and Tools, tools and resources to enhance the quality, speed, and public health impact of efforts to implement evidence-based care transformation.
PDSA (Plan, Do, Study, Act)
Resources and Tools:
- Institute for Health Improvement (IHI), 2019, The Plan-Do-Study-Act (PDSA) Worksheet, tools to support health care quality improvement and safety at every stage.
- Agency for Healthcare Research and Quality (AHRQ), 2019, Health Literacy Universal Precautions Toolkit, Plan-Do-Study-Act (PDSA) Directions and Examples.
CFIR (Consolidated Framework for Implementation Research)
Resources and Tools:
- Consolidated Framework for Implementation Research, overviews the foundational CFIR as a practical framework to help guide systematic assessment of potential barriers and facilitators which, in turn, can help guide tailoring of implementation strategies and needed adaptations, and/or explain outcomes.
- Implementation Sci, 2022, The updated Consolidated Framework for Implementation Research based on user feedback, incorporates user responses to the original 2009 Consolidated Framework for Implementation Framework (CFIR) for an updated assessment tool.(79)
Utilize electronic health record and claims data to illustrate CKD care among patients with hypertension and/or diabetes in the care team's patient panel.
Resources and Tools:
- NKF, Chronic Kidney Disease Data Analysis Strategy, a concise overview of unrecognized CKD plus data mining parameters via CKDintercept™ Practice Assessment.
Ensure the care team receives ongoing feedback about the agreed upon CKD interventions/quality metrics.
Resources and Tools:
- Agency for Healthcare Research and Quality (AHRQ), Do It Yourself Run Chart for Primary Care Practices, instructions and run chart example that can be used to create run charts to track quality improvement progress.
References
- 77. Bullock A, Burrows NR, Narva AS et al. Vital Signs: decrease in incidence of diabetes-related end-stage renal disease among American Indians/Alaska Natives—United States, 1996–2013. MMWR 2017 (66)1:26-32.
- 78. Fernandez ME, Ten Hoor GA, van Lieshout S et al. Implementation mapping: using intervention mapping to develop implementation strategies. Front. Public Health 2019 7:158.
- 79. Damschroder LJ, Reardon CM, Opra Widerquist MA et al. The updated consolidated framework for implementation research based on user feedback. Implement Sci. 2022 Oct 29:2-16.