Sea Mar Hypertension Quality Improvement Initiative 2011-2012

By Sara Barker, MPH, Chronic Care Program Director, Sea Mar

Small but impactful changes can be made to improve hypertension (HTN) management. Among these changes is accurate blood pressure measurement.

These were the messages interdisciplinary teams from 11 Sea Mar medical clinics heard on March 26, 2011, at the Hypertension Quality Improvement Initiative Project Launching Workshop. More than 60 Sea Mar employees attended the event sponsored by the Washington State Department of Health (DOH) Heart Disease and Stroke Prevention Program and Washington Healthy Communities Resource Center in partnership with Sea Mar.

The Project Launching Workshop was just the beginning of a Sea Mar-wide initiative to target the screening, measurement, and management of hypertension. Hypertension is one of the most common diagnoses at Sea Mar and is the leading cause of stroke and the second leading cause of chronic kidney disease nationwide.

The Initiative's goals include:

  • Increase the proportion of adults with high blood pressure whose blood pressure is under control.
  • Increase the proportion of adults who meet the recommended guidelines for prehypertension and hypertension.
  • Spread and sustain hypertension policies, procedures, QI tools, and data measures to all medical clinics and departments by the end of 2012.

The HTN Quality Improvement Initiative came out of Sea Mar's Chronic Care Program, which works to improve quality and patient centered care for patients with chronic conditions such as asthma, diabetes, and hypertension, and/or mental health diagnoses.

Chronic care teams at each medical clinic review clinical data and develop strategies to improve care at their clinic site.

The 11 pilot teams -- comprising a provider champion, nursing staff, health educator, chronic care coordinator, dietician, and pharmacist (depending on the clinic site) -- had an opportunity to practice and evaluate taking blood pressure based on standard measurement protocols. The teams also met to review data on the pilot provider's panel of hypertension patients and to discuss ways to improve the data and hypertension management at the clinic site.

Eleven Sea Mar medical clinics have a chronic care coordinator and five clinics have a behavioral health care coordinator. Care coordinators:

  • Assist the clinical practice teams in providing brief patient interventions before or after the provider visit.
  • Ensure that patients receive optimal care at the visit, which might include making Sea Mar and community referrals, completing labs, and following up with the patient after the visit.

Suhail Ahmad, MD, Medical Director of the Scribner Kidney Center, Chief Medical Officer for the Northwest Kidney Centers, and Medical Director for the Hypertension Clinic at the University of Washington (UW) Medical Center, was the keynote speaker who excited the audience with the news about those small changes.

Julia Wauters, RN, BSN, Manager of the UW Hypertension Clinic, and Colette Rush, RN, BSN, Quality Improvement Coordinator for the DOH Heart Disease and Stroke Prevention Program, discussed key messages for hypertension patients and the importance of accurate blood pressure measurement.

For additional questions about the Initiative or Chronic Care Program at Sea Mar, please contact Sara Barker, MPH, Chronic Care Program Director, 206-764-0526, sarabarker@seamarchc.org.