Previous Awardees
2023 Tyson Award Recipient
University of Chicago Medicine Systematic Treatment and Management of Postpartum Hypertension (STAMPP-HTN)
Systematic Treatment and Management of Postpartum Hypertension (STAMPP-HTN) is a series of interventions to improve postpartum care for women with hypertensive disorders of pregnancy (HDP) implemented at the University of Chicago Medicine, a tertiary urban care center with a predominantly Black and publicly insured patient population.
The STAMPP-HTM team implemented an intervention bundle, including:
- education to all patients and care providers
- updated clinic protocols for patients
- distribution of a STAMPP-HTN kit, which included a blood pressure monitor, instructions, warning signs, and a preeclampsia alert wrist bracelet, to all postpartum patients with an HDP
- consistent scheduling of follow-up appointments before discharge
- standardized protocols and workflows for the management of patients after hospital discharge
The initiative was implemented in phases to deploy additional interventions and further improvement over time. After the intervention bundle, telehealth visits and remote patient monitoring were made available.
These interventions significantly improved patient visit adherence and reduced the disparities between patient populations.
Results
At baseline, the rate of postpartum follow-up visit attendance within six weeks for a blood pressure check was:
- 30% for Black patients
- 53.5% for white patients
Once the intervention bundle was fully implemented, the rate of postpartum follow-up visit attendance improved to:
- 33.5% for Black patients
- 59.4% for white patients
Later, providing telehealth options (and continued use of the intervention bundle) further improved the rate of postpartum follow-up visit attendance to:
- 76.3% for Black patients
- 76.7% for white patients
This left only a 0.4% disparity between Black and white patients.
The final intervention, the implementation of a remote patient monitoring program, further improved the rate of postpartum follow-up visit attendance to 83.1%, with similar rates among Black and white patients, eliminating the disparity between Black and white patients.
Patients’ clinical outcomes also improved. After implementation, fewer patients experienced a blood pressure of 140/90 or higher at the first postpartum blood pressure check when compared with preintervention (18.5% vs. 39.1%, P<.004). The effect size did not differ by race.
Panel Notes
The Tyson Award panel was impressed by the comprehensive, multi-level bundle of interventions, engagement across departments, convenient ways patients could access information and care, and patient education and empowerment. They noted that the disparity was approached in a holistic way.
Use of telehealth and remote patient monitoring, in addition to the clinical interventions, resulted in improvement across all populations, but most significantly, decreased the disparity for Black patients. The panel acknowledged the significant clinical relevance, noting the size and impact of the improvement was remarkable.
The panel perceived that postpartum hypertension is a very specific and actionable clinical area and the UChicago Medicine team addressed the disparity in a way that could be replicable – like a roadmap – for other organizations to implement similar interventions to reduce disparities for their postpartum hypertensive patients.
2022 Tyson Award Recipients
NYC Health + Hospitals - In 2019, NYC Health + Hospitals, the largest municipal healthcare system in the nation, launched NYC Care, a citywide healthcare access program for New Yorkers who are ineligible for or cannot afford health insurance, including undocumented individuals. The city estimates that there over 400,000 undocumented immigrants who are uninsured and are more likely to forego essential primary and preventive care.
NYC Care provides access to low or no-cost primary and specialty care, prescription medicines, member materials in multiple languages, a membership card, and a 24-hour customer service line. The program leverages a system-wide integrated electronic medical record system, e-referral system, and telehealth platforms to provide high-quality, coordinated care to NYC Care members.
This initiative:
- Enrolled more than 100,000 members, who made 264,976 primary care visits and 227,481 specialty visits by February 2022.
- Improved clinical outcomes: After six months of enrollment, 51% of enrollees with diabetes had improved hemoglobin A1C, and 68% of enrollees with hypertension had improved blood pressure.
See below link to learn more about their initiative, strategies employed, interventions implemented, and key take-aways for replicability.
Texas Children’s Pavilion for Women - In March 2019, Texas Children’s Pavilion for Women began stratifying data by race and ethnicity and determined that non-Hispanic Black women had the highest rates of severe maternal morbidity from hemorrhage (SMM-H). A gap analysis identified interventions to reduce morbidity from hemorrhage for all pregnant patients, including hemorrhage risk assessment, drills, active management of the third stage of labor, and a multidisciplinary review of serious hemorrhages to identify systematic issues. A health equity lens was applied to these efforts and Black/African American race was added as a medium risk factor for hemorrhage to help address implicit bias and accelerate healthcare team response.
Prior to implementation of these strategies, there was a statistically significant difference between Black and White women for SMM-H rates (p<0.001). This disparity was no longer significant post-intervention (p=0.138), and the rate of SMM-H in Black women decreased significantly from 45.5% to 31.6% (p=0.011). This team’s initiative was described In further detail in Examining the effect of quality improvement initiatives on decreasing racial disparities in maternal morbidity which was published in BMJ Quality & Safety.
See below link to learn more about their initiative, strategies employed, interventions implemented, and key take-aways for replicability.
2021 Tyson Award Recipient
A UMass Memorial Health team identified and addressed disparities in adherence to well-child visits and guided their initiative with robust and ongoing use of data stratified by race, ethnicity, and language.
The multidisciplinary team interviewed external and internal stakeholders, patients and families. Barriers to adherence for well-child visits identified included transportation, language and scheduling. To improve accessibility and adherence to regular well-child visits, multiple strategies to overcome these barriers were implemented:
- Conducting well-child visits during acute care appointments
- Scheduling the next visit at the time of the current visit
- Providing patients and their families with an information sheet highlighting the importance of preventive care visits
- Implementing an improved reminder system
- Making telehealth appointments available
- Arranging transportation
- Actively reaching out to patients who canceled or were “no-shows” for their visits to reschedule
- Creating a well-child tip sheet to help measure success
In just nine months during the COVID-19 pandemic, adherence to child well-visits among Latino pediatric patients rose from 64 percent at baseline to 76 percent; among Black children, adherence improved from 59 percent to 75 percent.
See below link to learn more about their initiative, strategies employed, interventions implemented, and key take-aways for replicability.
UMass Memorial Health - Prioritizing Child Health: Promoting Adherence to Well-Child Visits