Improving hypertension detection and referral in an ambulatory setting

Area of Science:

• Public Health
• Clinical Nursing
• Health Services Research

Background:

• Hypertension management requires consistent patient monitoring and follow-up.
• Urban ambulatory clinics face challenges in ensuring timely hypertension detection and referral.
• Innovative staffing models may improve patient care efficiency.

Purpose of the Study:

• To evaluate the effectiveness of a paraprofessional health aide in improving hypertension detection and referral in an urban hospital ambulatory clinic.
• To assess the impact of the health aide intervention on blood pressure recording rates, appointment keeping, and initiation of management for hypertensive patients.

Main Methods:

• A paraprofessional health aide encouraged nurses to record blood pressures and proactively contacted patients with elevated readings.
• The intervention involved patients not referred by clinic staff or those who did not return for follow-up.
• Data were collected on blood pressure recording, appointment keeping, and initiation of management before and during the intervention.

Main Results:

• Blood pressure recording increased from 54% to 68% of patients seen.
• Appointment keeping for eligible patients rose from 13% to 73%.
• The identification of hypertensive patients initiating management increased from 7% to 22% of eligible patients.

Conclusions:

• A health aide can be a cost-effective resource for enhancing hypertension detection and referral in ambulatory care settings.
• Proactive patient outreach by health aides improves follow-up rates and management initiation.
• This intervention demonstrates a successful strategy for improving chronic disease management in urban healthcare environments.