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Sustained Implementation of Patient-Centered Care for Alcohol Misuse

Award Number: R18HS023173
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)
PERIOD OF PERFORMANCE START DATE: 09/01/2014
PERIOD OF PERFORMANCE END DATE: 08/31/2019

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Sustained Implementation of Patient-Centered Care for Alcohol Misuse - DESCRIPTION (provided by applicant): Alcohol use is the third greatest cause of disability and death for US adults. Alcohol misuse refers to the spectrum ranging from drinking above recommended limits to alcohol use disorders ("AUD"). Care for alcohol misuse is generally neglected in primary care (PC). Two types of evidence-based care for alcohol misuse are lacking: preventive care and treatment of AUD. Evidence-based preventive care consists of alcohol screening and, for patients who screen positive, brief patient-centered counseling. This is called "screening and brief intervention" (SBI), and is recommended by the US Preventive Services Task Force (USPSTF). Most PC practices do not offer SBI. Evidence-based treatments for AUD include counseling, medications, and/or specialty treatment. In spite of these options, however, few patients with AUD are offered treatment and when they are, referral to group-based specialty addictions treatment is often all that is offered. Many patients do not find the offered treatment acceptable, and 91% of those with AUD do not receive alcohol treatment. These gaps in care result from complex historical and social factors. Alcohol misuse is stigmatized, alcohol treatment has historically been offered outside medical settings, and AUD treatment is neglected in health professional training. PC clinicians often do not perceive care for alcohol misuse as central to their practice. Objective: The proposed project will use three strategies to improve the quality of care for alcohol misuse in the 25 PC clinics of a regional health system-Group Health Cooperative (GHC): (1) enabling with proven methods for obtaining buy-in, and improving attitudes, skills, knowledge and self-efficacy; (2) supporting with an electronic health record (EHR); and (3) monitoring and feedback on performance by PC leaders. Implementation Plan: Currently, there is no systematic documentation of SBI for the estimated 381,550 patients who receive PC in GHC, and only an estimated 148 patients a year are provided treatment for AUD. We will leverage GHC's EHR and quality improvement processes, as well as GHC leaders' recognition of gaps in the quality of alcohol- related care, to spread and sustain improvements in alcohol-related care across 25 clinics. Specifically, we will implement SBI and patient-centered care for AUD, reframing AUD management as shared-decision making to help PC teams embrace patient-centered alcohol-related care. Our proposed implementation strategies will build on our previous experience collaborating on implementation of SBI in over 900 clinical sites in the VA and successfully implementing sustained PC innovations in GHC. Impact: We estimate that after full implementation each year: more than 45,000 patients will receive preventive brief alcohol counseling who otherwise would have gone without and more than 1,050 patients would receive care for AUD who would otherwise have gone untreated. In addition, this work will create a roadmap and widely available online tools for other health care organizations needing to improve the quality of alcohol-related care, and will be disseminated in a national summit in Year 4.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = -$97 )
2023	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	1300 SW 27TH ST	RENTON	WA	98057	KING	USA	Research on Healthcare Costs, Quality and Outcomes	001	4	12/27/2022	NON-COMPETING CONTINUATION	-$48
2023	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	1300 SW 27TH ST	RENTON	WA	98057	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	12/21/2022	NON-COMPETING CONTINUATION	-$48
														Subtotal = -$97

Issue Date FY: 2021 ( Subtotal = -$1 )
2021	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	601 UNION ST STE 3100	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	11/6/2020	NON-COMPETING CONTINUATION	-$1
														Subtotal = -$1

Issue Date FY: 2020 ( Subtotal = -$48 )
2020	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	601 UNION ST STE 3100	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	12/2/2019	NON-COMPETING CONTINUATION	-$48
														Subtotal = -$48

Issue Date FY: 2018 ( Subtotal = $0 )
2018	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	601 UNION ST STE 3100	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	7/9/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2017 ( Subtotal = $467,400 )
2017	2017	KAISER FOUNDATION HEALTH PLAN OF WASHINGTON	600 UNIVERSITY ST STE 3100	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	9/1/2017	NON-COMPETING CONTINUATION	$467,400
														Subtotal = $467,400

Issue Date FY: 2016 ( Subtotal = $460,837 )
2016	2016	GROUP HEALTH COOPERATIVE OF PUGET SOUND	1730 MINOR AVE, SUITE 1600	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	8/29/2016	NON-COMPETING CONTINUATION	$460,837
														Subtotal = $460,837

Issue Date FY: 2015 ( Subtotal = $468,368 )
2015	2015	GROUP HEALTH COOPERATIVE OF PUGET SOUND	1730 MINOR AVE, SUITE 1600	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	8/27/2015	NON-COMPETING CONTINUATION	$468,368
														Subtotal = $468,368

Issue Date FY: 2014 ( Subtotal = $483,414 )
2014	2014	GROUP HEALTH COOPERATIVE OF PUGET SOUND	1730 MINOR AVE, SUITE 1600	SEATTLE	WA	98101	KING	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/1/2014	NEW	$483,414
														Subtotal = $483,414

Grand Total All Awards = $1,879,873

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Sustained Implementation of Patient-Centered Care for Alcohol Misuse

Award Number: R18HS023173

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

PERIOD OF PERFORMANCE START DATE: 09/01/2014

PERIOD OF PERFORMANCE END DATE: 08/31/2019

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