An evidence-based set of changes that will guide community health centers and other primary care providers in accurately identifying patients with hypertension and applying treatment and practices to control it.
O V E R V I E W
Team-based care uses multidisciplinary teams (which may involve new staff, or the shifting of tasks among existing staff). Teams can include patients themselves, primary care physicians, and other allied health professionals, such as nurses, pharmacists, counsellors, social workers, nutritionists, community health workers, or others. Teams reduce the burden on physicians by utilizing the skills of trained health workers. Strong evidence shows that team-based care is effective in improving hypertension control among patients in a cost-effective way. Some amount of task shifting/team-based care is already taking place in many settings.
KEY
DRIVERS
Ways to establish practice foundations for effective hypertension control efforts and is likely the best place on which to focus initial quality improvement efforts. These include identifying a champion to provide leadership on focused quality improvement efforts, making HTN a practice priority, and expanding the HTN care team.
Key Driver: Accurate Blood Pressure Measurement
Accurate blood pressure measurement is a critical and foundational driver for hypertension diagnosis and treatment. Providers need to trust the blood pressure readings in order to provide appropriate care, including prescribing the right medications in the correct dosage.
CHANGE CONCEPT: Established training program for all staff involved in BP measurement
CHANGE IDEA
Incorporate BP measurement training into the orientation of all new staff (involved in BP measurement) at the facility level
TOOLS & RESOURCES
— Train core team of person at the facility level to become mentors and those in supervisory positions
— Assess competency of new staff
— Standardized training package (video, infographic, one-on-once session with trained mentor or supervisor)
— Mandated as part of the orientation of staff including interns
— Establish system for validation of technique (at different intervals)
— Institutionalized by incorporating into the general training policy of the Ministry/RHA/Facility
— Certification/re-certification – virtual course, local university
— Establish re-certification date