Abstract Body (Do not enter title and authors here): Objectives: Improve clinical pathways to impact atherosclerotic cardiovascular disease (ASCVD) management of Veterans through a Learning Healthcare System model of quality improvement designed to improve the management of dyslipidemia among those with high-risk ASCVD.
Methodology: Long Beach VA (LBVA) is one of 50 VA sites participating in a national quality improvement initiative called the VALOR QI: VA Lipid Optimization Reimagined Quality Improvement Project. VALOR-QI is a collaborative project between the U.S. Department of Veterans Affairs (VA) and the American Heart Association (AHA) with the goal of positively impacting Veterans’ cardiovascular (CV) health. As part of the program, VA sites work with an AHA QI Consultant develop and deploy a local quality improvement plan to help overcome site specific barriers preventing Veterans from achieving optimal cholesterol levels.
At the LBVA, patients with LDL-C>70 and an ASCVD diagnosis are screened from a list generated by the health care provider. If a patient meets criteria, the health coach approaches the patient and begins working with them once a month over the phone or in person. During these meetings medication compliance and refills are reviewed, lifestyle goals or progress are reevaluated, and patients are reminded of upcoming appointments and labs.
Results: Since October 2022, the LBVA VALOR-QI program has directly interacted with 277 patients who have a high ASCVD risk and LDL-C>70. Of those 277 patients, 84 patients (30%) have reached an LDL-C<70. As of June 2024, 16 patients have maintained their LDL-C<70 for more than 6 months. Patients that have participated since October 2022 have seen a 59% improvement in LDL-C and 50% of those patients have reached goal. The VALOR-QI program collaborates with 8 different primary care or heart failure clinics and some clinics have experienced up to 53% of patients reaching LDL-C<70.
Conclusions: The VALOR-QI program at the LBVA has demonstrated the effectiveness of a dual process approach of 1) active health coaching – working directly with patients on lifestyle changes, medication management, and healthcare reminders and 2) collaborating with patients’ providers on intensifying medication or referring to pharmacy or cholesterol clinics.