Abstract P847: Exploring the Perspective of Patient Recipients of a Provider and Systems-Level Intervention - A Mixed Methods Analysis From the Care Transitions and Hypertension Management (catch) Program for Ischemic Stroke Study

Abstract

Introduction: The CAre Transitions and Hypertension management (CATcH) program was developed using Lean Six Sigma methodology and is a bundled, multi-faceted, provider- and healthcare systems-level pilot-intervention designed to enhance care coordination. Components of the intervention included: education delivered during the hospitalization, increased utilization of clinical pharmacy and home telehealth for blood pressure (BP) monitoring, and a patient care navigator. Hypothesis: Recipients of CATcH will find the program valuable though engaging with additional care providers may be deemed onerous. Methods: Twenty-eight semi-structured qualitative interviews were conducted between June 2018 and June 2019 among CATcH recipients. Interviews were audio-recorded, transcribed, and entered into an ATLAS.ti. project file. Thematic Content Analysis was used to analyze coded data, generate, and validate findings. Themes related to the overall impression of CATcH and its individual components were investigated across all patients and stratified by age, race, sex, and when they were discharged in relation to beginning of CATcH implementation. Results: A total of 108 Veterans were the recipients of CATcH. All patients received education, patient care navigator services, and offered both clinical pharmacy and telehealth services, with 52/108 (48.1%) attending clinical pharmacy appointments and 37/108 (34.3%) utilizing telehealth services within 6-months post-discharge. Subjects interviewed were on average 68.6±8.2 years of age, predominantly male (26/28; 92.9%) and equally distributed among black and non-black races. Themes were largely positive with patients expressing they were unaware that they were the recipients of an enhanced care program, and that CATcH. Patients who received CATcH in the second half of the program reported better care collaboration and more useful educational materials that those enrolled earlier in the project. Conclusions: Patients found the CATcH program and its component parts useful in the ongoing management of post-stroke BP control. Continuous self-evaluation and refinement of the program throughout the intervention period likely contributed to improvements in care collaboration and education.