Getting Back On Track With Blood Pressure Control: 1815 Year 4
Overview
Coteau des Prairies Health Care System has been partnering with the South Dakota Department of Health Heart Disease and Stroke Prevention Program (HDSPP) since 2019 to address quality improvement needs, expand use of team-based care, and implement self-measured blood pressure monitoring. They understand the importance of moving toward patient-centered care and assisting with patient goal decision making as evidenced by their continued focus on prevention and management programming through a team-based approach. Patients appreciate the patient-centered care, one-on-one coaching, and adoption of the care coordination model. Additionally, the improved outcomes and engagement for both patients and staff have been positive results of this work. Providers have responded positively to feedback data and overall clinic goals have improved.
Solutions
COVID-19 remains a barrier to getting patients back in for routine check-ups as many people have put wellness and health maintenance on pause during a time when stress levels may be high. It is important to encourage patients to get back to their routine doctor visits, take medications as directed, and regularly track their blood pressure measurements to ensure blood pressure control. At Coteau des Prairies, several methods have been employed to promote these steps:
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Using marketing strategies to influence health mindfulness
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Working with staff to take time at every visit to talk about overall health, including heart health
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Continuing to educate providers and staff by scheduling training sessions during medical staff meetings
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Utilizing the Quality Coordinator to highlight performance data, follow-up, and educational resources and tools for improvement
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Enhancing the existing self-measured blood pressure monitoring program (SMBP) by assigning a clinic champion to monitor blood pressure cuff usage, supplies, and materials
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Streamlining access to SMBP, including the process for checking cuffs in and out and distributing educational materials
Results
Slowly, patients are getting back to routine and chronic disease self-management while Coteau des Prairies’ providers continue to use SMBP as a tool to assist in treatment. During Year 4 (June 30, 2021–June 29, 2022), 50 individuals enrolled in the program; 30 of those individuals completed the program by the end of the project period. During that time, 17 medication changes were implemented and 10 participants were identified as having controlled blood pressure (less than 140/90 mm Hg), meaning no additional treatment plan changes were necessary. In comparison, during Year 3 (July 1, 2020–June 30, 2021), 21 out of 37 participants completed the program, with 18 needing medication changes and eight having controlled blood pressure. In Year 2 (July 1, 2019–June 30, 2020), Coteau des Prairies enrolled 14 participants in SMBP, of which seven completed the program. One individual had controlled blood pressure, and nine required medication changes to get their blood pressure under control. The upward trend in SMBP utilization over the past three years is reflected through the facility’s collected data, indicating improved clinical decision making.
Next Steps
Through CDC’s 1815 cooperative agreement, Coteau des Prairies receives continued funding from the HDSPP in 2022–2023. During Year 5, they will focus on:
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Implementing creative methods to educate staff on tools and resources available through their monthly “stoplight”
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Looking at optimizing resources available through HDSPP, such as having the Better Choices, Better Health team present to medical staff
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Continuing to follow previously developed action plans
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Utilizing more structured care coordination programming
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Focusing on expanding services to further support wrap-around care
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Creating a process to better connect patients to services available within Coteau des Prairies’ Health Care System
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Working to develop a shared patient education space to improve efficiency, engagement, and satisfaction for patients and providers
