Abstract
We evaluated use of a program to improve blood pressure measurement at 6 primary care clinics over a 6-month period. The program consisted of automated devices, clinical training, and support for systems change. Unannounced audits and electronic medical records provided evaluation data. Clinics used devices in 81.0% of encounters and used them as intended in 71.6% of encounters, but implementation fidelity varied. Intervention site systolic and diastolic blood pressure with terminal digit "0" decreased from 32.1% and 33.7% to 11.1% and 11.3%, respectively. Improvement occurred uniformly, regardless of sites' adherence to the measurement protocol. Providers rechecked blood pressure measurements less often post-intervention (from 23.5% to 8.1% of visits overall). Providers at sites with high protocol adherence were less likely to recheck measurements than those at low adherence sites. Comparison sites exhibited no change in terminal digit preference or repeat measurements. This study demonstrates that clinics can apply a pragmatic intervention to improve blood pressure measurement. Additional refinement may improve implementation fidelity.
| Original language | English (US) |
|---|---|
| Journal | Journal of clinical hypertension |
| DOIs | |
| State | Accepted/In press - Jan 1 2017 |
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Keywords
- Blood pressure measurement
- Chronic disease
- Hypertension
- Implementation science
- Primary care
- Quality improvement
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Cardiology and Cardiovascular Medicine
Cite this
A bundled quality improvement program to standardize clinical blood pressure measurement in primary care. / Boonyasai, Romsai Tony; Carson, Kathryn Anne; Marsteller, Jill A; Dietz, Katherine B.; Noronha, Gary J.; Hsu, Yea-Jen; Flynn, Sarah J.; Charleston, Jeanne B; Prokopowicz, Gregory P; Miller, Edgar R; Cooper, Lisa A.
In: Journal of clinical hypertension, 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A bundled quality improvement program to standardize clinical blood pressure measurement in primary care
AU - Boonyasai, Romsai Tony
AU - Carson, Kathryn Anne
AU - Marsteller, Jill A
AU - Dietz, Katherine B.
AU - Noronha, Gary J.
AU - Hsu, Yea-Jen
AU - Flynn, Sarah J.
AU - Charleston, Jeanne B
AU - Prokopowicz, Gregory P
AU - Miller, Edgar R
AU - Cooper, Lisa A
PY - 2017/1/1
Y1 - 2017/1/1
N2 - We evaluated use of a program to improve blood pressure measurement at 6 primary care clinics over a 6-month period. The program consisted of automated devices, clinical training, and support for systems change. Unannounced audits and electronic medical records provided evaluation data. Clinics used devices in 81.0% of encounters and used them as intended in 71.6% of encounters, but implementation fidelity varied. Intervention site systolic and diastolic blood pressure with terminal digit "0" decreased from 32.1% and 33.7% to 11.1% and 11.3%, respectively. Improvement occurred uniformly, regardless of sites' adherence to the measurement protocol. Providers rechecked blood pressure measurements less often post-intervention (from 23.5% to 8.1% of visits overall). Providers at sites with high protocol adherence were less likely to recheck measurements than those at low adherence sites. Comparison sites exhibited no change in terminal digit preference or repeat measurements. This study demonstrates that clinics can apply a pragmatic intervention to improve blood pressure measurement. Additional refinement may improve implementation fidelity.
AB - We evaluated use of a program to improve blood pressure measurement at 6 primary care clinics over a 6-month period. The program consisted of automated devices, clinical training, and support for systems change. Unannounced audits and electronic medical records provided evaluation data. Clinics used devices in 81.0% of encounters and used them as intended in 71.6% of encounters, but implementation fidelity varied. Intervention site systolic and diastolic blood pressure with terminal digit "0" decreased from 32.1% and 33.7% to 11.1% and 11.3%, respectively. Improvement occurred uniformly, regardless of sites' adherence to the measurement protocol. Providers rechecked blood pressure measurements less often post-intervention (from 23.5% to 8.1% of visits overall). Providers at sites with high protocol adherence were less likely to recheck measurements than those at low adherence sites. Comparison sites exhibited no change in terminal digit preference or repeat measurements. This study demonstrates that clinics can apply a pragmatic intervention to improve blood pressure measurement. Additional refinement may improve implementation fidelity.
KW - Blood pressure measurement
KW - Chronic disease
KW - Hypertension
KW - Implementation science
KW - Primary care
KW - Quality improvement
UR - http://www.scopus.com/inward/record.url?scp=85038841768&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038841768&partnerID=8YFLogxK
U2 - 10.1111/jch.13166
DO - 10.1111/jch.13166
M3 - Article
JO - Journal of clinical hypertension
JF - Journal of clinical hypertension
SN - 0895-7061
ER -