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Development of a Multistep Hypertension Quality Improvement Program in an Academic General Medicine Practice

Mai-Khanh Bui-Duy, Shirley Wong, Rosemary Lam

    Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
    |May 17, 2019
    PubMed

    Insights

    Implementing a quality improvement program in academic general medicine successfully improved blood pressure (BP) control for many patients with hypertension. Further efforts are needed to overcome barriers to intensive BP management and team-based care.

    Area of Science:

    • Cardiology
    • General Medicine
    • Quality Improvement

    Background:

    • Hypertension is a significant cardiovascular disease risk factor.
    • Effectiveness of blood pressure (BP) control strategies in academic settings remains unclear.
    • Quality improvement initiatives are crucial for managing chronic diseases.

    Purpose of the Study:

    • To implement and evaluate a quality improvement program for uncontrolled hypertension in an academic general medicine practice.
    • To assess the impact of improved BP measurement and electronic medical record (EMR) data feedback on BP control.
    • To identify barriers and facilitators for integrating pharmacists into hypertension management teams.

    Main Methods:

    • A multistep quality improvement program was implemented.
    • Medical assistants were trained in accurate BP measurement.
    • EMR-based registry data facilitated provider-level feedback for panel management.
    • An initial integration of a pharmacist into the care team was attempted.

    Main Results:

    • Accurate BP measurement and EMR data feedback led to significant BP improvements for many patients.
    • Patients with more frequent practice visits showed particular improvement.
    • Integration of a pharmacist was successful for only a limited number of patients due to various barriers.

    Conclusions:

    • A quality improvement program can enhance BP control in academic general medicine.
    • Addressing PCP, patient, and system barriers is essential for effective hypertension management.
    • Team-based care and adaptation are necessary for population-based chronic disease management.

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