Introduction:
In September 2011, the Centers for Medicare & Medicaid Services and the Centers for Disease Control launched the
Million Hearts
campaign - a national public health initiative with the goal of reducing the number of heart attacks and strokes suffered in the US by 1 million over the next 5 years. Multiple federal agencies and private health care institutions have committed to become
Million Hearts
partners and bring their resources to bear in order to achieve this goal. The
Million Hearts
goal will be reached by the substantial reduction of dietary sodium and
trans
fats and by improving the “ABCS” of clinical prevention: Aspirin use for indicated conditions, Blood pressure control, Cholesterol treatment, and Smoking cessation counseling or medications. These four clinical performance measures are within the ken of practicing physicians and are readily measured in the American College of Cardiology’s (ACC) PINNACLE Registry. As a
Million Hearts
partner, the ACC pledged to provide data and engage in performance improvement initiatives to increase compliance with the four clinical measures. In this study, we compared compliance rates from PINNACLE to the
Million Hearts
baseline estimates for the nation and to their 2017 cardiovascular goals.
Methods:
The PINNACLE Registry contains data from more than 2.5 million outpatient encounters recorded over the past four years - representing approximately 800,000 discrete patients. Around 1,000 providers electronically submit data to PINNACLE and receive quarterly performance reports. Data queries determined PINNACLE provider compliance with analogs of the four
Million Hearts
performance measures.
Results:
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Conclusion:
Baseline performance measures in PINNACLE are favorable compared to the
Million Hearts
initial national estimates and 5-year goals.
Million Hearts
goals are population-level targets based on national survey data whereas PINNACLE patients are, by definition, in care, so some elevation of rates in the latter cohort is to be expected. There is, however, room for improvement in three of the four PINNACLE baseline performance measures. Concordant with the plans of the
Million Hearts
executive and scientific leadership, initial improvement efforts developed by the ACC will be directed toward improvement in blood pressure control of patients in the PINNACLE Registry. As the
Million Hearts
initiative moves forward, we can undertake formal efforts to learn from the higher rates of measure adherence and performance seen in cardiology practices by using top PINNACLE sites as a source for modular best practices around the ABCS.
Shining light on the paraventricular nucleus: the role of glutamatergic PVN neurons in blood pressure control