THE PATIENT ALIGNED CARE TEAM (PACT) MODEL: A COMPARATIVE ANALYSIS OF NATIONAL STANDARD PATIENT CENTERED MEASURES FOLLOWING R Morgan Tolley, Tiffany Jagel, Vanessa Herrington, Frances Hoffman Gulf Coast Veterans Health Care System - Biloxi, MS
Background/Purpose: Within the VA primary care setting, a patient aligned care team (PACT) functions to provide an interdisciplinary health care delivery system which integrates the skills of the clinical pharmacy specialist (CPS), who has prescriptive authority specific to a scope of practice. This integration has proven to expand overall appointment availability and improve patient outcomes and safety.
Methodology: National standards of performance measures, Strategic Analytics for Improvement and Learning (SAIL) and Healthcare Effectiveness Data and Information Set (HEDIS), for Veterans Integrated Service Network (VISN) 16 will be used for primary data analysis. Eligible veterans identified through the Primary Care Almanac will be recruited and scheduled into CPS clinics hemoglobin a1c > 9% and BP > 140/90 mmHg. To target access, a measure of SAIL, CPS capacity scorecards, source of patient referrals, and conversion of primary care physician (PCP) appointments will be measured.
Results: A total of 459 patients were seen by PACT CPSs from September 2018 to January 2019. Of the 459, 239 were recruited during PACT expansion (CPS 50.2%, primary care 47.7%, and other 2.1%). Overall capacity versus patients scheduled has remained stable with average capacity score of 62.6% from 10/22/18 through 1/18/19. Core HEDIS measure a1c poorly controlled (a1c > 9%) remained stable with a decrease in performance for blood pressure control (BP > 140/90 mmHg).
Conclusions: CPS integration into PACT helped maintain HEDIS measure performance. Increasing access for veterans in primary care was supported by the indirect measurement of appointment conversions and clinic capacity measurements. On average, CPS clinics dedicated at minimum 60 hours a week serving veterans.
Presentation Objective: This project will use national standards of performance measures to assess the expansion of the PACT model within the GCVHS.
Self-Assessment: In what ways can CPSs improve patient outcomes within the primary care setting?
