Preventing Heart Attacks and Strokes Everyday (PHASE)

PHASE is a population health management program designed to reduce the risk of heart attacks and strokes in patients at high risk. PHASE follows Kaiser Permanente’s evidence-based protocol that has been shown to prevent one heart attack or stroke for every ten patients successfully enrolled in the program for five years. PHASE targets patients with diabetes mellitus, hypertension, and known vascular disease for a handful of interventions designed to control blood sugar, blood pressure, and weight, to prescribe cardio-protective medications, to assist in cessation of smoking, and to identify and manage patients at risk for depression.

To learn more about PHASE, check out this brief video from Kaiser Permanente!

Goal

By March 31, 2021, we will: (1) manage chronic conditions of high-risk populations to decrease their risk of cardiovascular disease (CVD) and/or cardiovascular events; (2) improve ability to screen for key CVD risk factors as well as the ability to follow-up with patients who have those risk factors; and (3) advance health equity by achieving high performance for all populations on measures impacting cardiovascular health.

Population served

Adults 18 and over with a current or previous diagnosis of diabetes mellitus, hypertension, coronary artery disease (Heart Disease), TIA (transient ischemic attack) or Cerebrovascular Accident (Stroke).

Timeline

January 1, 2020 - March 31, 2021

Funders

Kaiser Permanente Northern California Community Benefit Programs

Partners

Data

PHASE Clinical and Quality Measures - Clinic Report Template PHASE Clinical and Quality Measures - Clinic Report Template (51 KB)

PHASE Clinical and Quality Measures - Data Definitions PHASE Clinical and Quality Measures - Data Definitions (470 KB)


2017 Q1 Consortium Baseline Results 2017 Q1 Consortium Baseline Results (32 KB)

2020 Q2 Consortium Recent Performance 2020 Q2 Consortium Recent Performance (1900 KB)


Resources

Adult Diabetes Clinician Guide Adult Diabetes Clinician Guide (4962 KB)

Management of Adult Hypertension Blood Pressure Goals Management of Adult Hypertension Blood Pressure Goals (304 KB)

PHASE on a Page 03.20.2019 PHASE on a Page 03.20.2019 (339 KB)


Screening Tools

CHP PHASE Toolkit 2017 CHP PHASE Toolkit 2017 (14295 KB)

HTN_Change_Package HTN_Change_Package (625 KB)

CCI PHASE Onboarding Playbook