Describe the common themes associated with your selected evidence-based intervention from literature

Describe the common themes associated with your selected evidence-based intervention from literature. To implement evidence-based and best practice tools for tracking and monitoring patients at risk for stroke, as well as addressing social determinants of health (SDOH) impacting their health, the following focus areas should be researched: Risk Assessment Tools for Stroke: Clinical Risk Factors: Research tools like the Age, Blood Pressure, Clinical Features of TIA, Duration, and Diabetes (ABCD²) score use have been recommended in national guidelines and it is a risk assessment tool designed to improve the prediction of short-term stroke risk within 2 days after a transient ischemic attack (TIA) and also predicts stroke risk within 90 days (Giles et.al, 2011). The “PREVENT” risk assessment tool, developed by the American Heart Association, is a calculator used to estimate a person’s 10-year and 30-year risk of developing cardiovascular diseases like stroke, heart attack, and heart failure, taking into account risk factors including age, sex, race, blood pressure, cholesterol levels, (Khan et.al, 2023) Integration of SDOH in Health Assessments: Data Collection Methods: Explore validated tools and surveys that capture SDOH, such as the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE- a tool designed to equip healthcare and their community partners to better understand and act on individuals’ social drivers of health (Wan et.al, 2022) Community Engagement and Resource Utilization: Partnership Development: Investigate best practices for forming partnerships with local organizations, community centers, and health departments to leverage resources. Technology and Remote Monitoring: Wearable Technology: Look into evidence-based guidelines for using wearable devices in monitoring heart rate, blood pressure, and other vital signs related to stroke risk (Centers for Disease Control [CDC]: Best Practices for Heart Disease and Stroke, (n.d.)Telehealth Solutions: Research the effectiveness of telehealth platforms for regular check-ins, health education, and patient engagement (Centers for Disease Control [CDC]: Best Practices for Heart Disease and Stroke, (n.d.). Education and Awareness Programs: Health Literacy Improvement: Develop strategies for improving health literacy to ensure patients understand their risk factors, the importance of monitoring, and available resources. Outcomes Measurement and Continuous Improvement: Quality Improvement Frameworks: Research frameworks such as Plan-Do-Study-Act (PDSA) cycles to evaluate the effectiveness of implemented tools and approaches. To address the HP2030 objective of reducing the risk of stroke in outpatient settings, there is a critical need to enhance hypertension and hypercholesterolemia management through comprehensive and multifaceted interventions (Bertoni et.al, 2009). As the fifth leading cause of death in the United States and a primary contributor to long-term disability, strokes necessitate rigorous prevention and management strategies (U.S. Department of Health and Human Services, n.d.). Unfortunately, existing healthcare processes fail to provide comprehensive screening and referral systems for patients at elevated risk of stroke, particularly those with comorbid conditions such as hypertension and high cholesterol, which increase stroke vulnerability. The observations from the Gemba walk and patient assessments highlight the critical need for enhanced patient flow management and improved communication and coordination of protocols among healthcare providers. Problem Statement Strokes are a critical public health issue due to their prevalence and substantial impact on individuals and the healthcare system. They are the 5th leading cause of death in the United States and a leading cause of long-term disability, highlighting the urgent need for effective prevention and management strategies (U.S. Department of Health and Human Services, (n.d.). The current processes in place lack comprehensive screening and referral systems for patients at elevated risk of stroke, particularly those with hypertension and high cholesterol, which exacerbate stroke risk. Clinical Patient Assessments Patient assessments have underscored the absence of formal screening tools and referral systems to identify and assist those at high risk for strokes. This diagnostic gap necessitated adjustments to the proposed project to include these essential components for effective intervention. Alignment with Healthy People 2030 Objectives The project aligns with the Healthy People 2030 objective HDS-03, which aims to reduce the number of stroke-related deaths (U.S. Department of Health and Human Services-Reduce Stroke Deaths, (n.d.). By addressing gaps in risk assessment and management, the project supports national goals for improving stroke prevention outcomes and reducing mortality rates.

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