title: Process improvements and shared medical appointments for cardiovascular disease prevention in women.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is clinically unique in women and is often underdiagnosed and undertreated. Chronic diseases account for 75% of healthcare expenditures in the United States, of which 70% are preventable through lifestyle changes and active medical management. Lifestyle modification is difficult in the context of the traditional medical visit.
  
  
  METHODS
  The Club Red Clinic uses a novel approach to enhance the care of women at risk for or with CVD. Through shared medical appointments (SMAs) and a multidisciplinary team approach, Club Red provides lifestyle training in addition to evidence-based practice to reduce CVD risk factors in women. In Club Red, nurse practitioners function independently and effectively in delivering lifestyle intervention for the management and prevention of CVD.
  
  
  METHODS
  The clinic functions within an academic medical school at the University of Virginia.
  
  
  METHODS
  Patient access, patient satisfaction, provider efficiency, and frequency of cardiovascular visits.
  
  
  RESULTS
  Process improvements include reduced appointment wait times, improved provider efficiency (more patients seen with the SMAs), high patient satisfaction (96%), and improved adherence to recommended medical monitoring (3.8 visits/year).
  
  
  CONCLUSIONS
  Club Red improved patient access, patient satisfaction, medical and behavioral management, and health promotion education for women with or at risk for CVD.
authors.affiliation: Department of Obstetrics/Gynecology, University of Virginia, Charlottesville, Virginia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Pastore
authors.forename: Ann M
authors.initials: AM
authors.lastname: Rossi
authors.forename: Amy L
authors.initials: AL
authors.lastname: Tucker
mesh_terms: D001071:Appointments and Schedules; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D019468:Disease Management; D005260:Female; D006126:Group Processes; D006801:Humans; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care / Q000379:methods*; D014481:United States
keywords: Chronic cardiac care; cardiology; group visit; health education; lifestyle modification; nurse practitioner; shared medical appointments