Implementation of Evidence-Based Blood Pressure Management Guideline to Improve Blood Pressure in Control

Abstract

One in every three adults in the United States are diagnosed with hypertension and only half of this population has their blood pressure in control. The rate of uncontrolled hypertension in North Carolina is 35% and at least 26% of this population expire each year. With the added responsibility from the CMS benchmark goals, family practices are searching for innovated ways to manage blood pressure in control. While effective blood pressure guidelines exist, a family practice site in eastern North Carolina currently uses no standard guideline interventions to control blood pressure, therefore a quality improvement project that included a modified version of the Heart Health Now guideline was implemented over a 12-week interval. The purpose of the project was to evaluate staff guideline compliance, modifying steps for blood pressure measurements, and referrals for continuous follow-up. The guideline included standardized steps in blood pressure measurements, use of an educational hypertension brochure, and Telehealth referrals. Of the 17 patients, 11 (65%) met the modified HHN guideline and Telehealth referral criteria. Improvement was noted in staff compliance in blood pressure measurement adequacy and increase in the number of Telehealth referrals. The organization blood pressure in control improved to 61% compared to 52% prior to the project implementation. This was an improvement by 9%. This evidence-based quality improvement project did improve staff and provider compliance and changed the family practice cultural behavior without increasing the workload for the staff thereby improving delivery of care.