While the original focus on numbers was with the clinic’s
non-diabetic population, we are utilizing this same process
for diabetic patients with a goal BP of < 130/80. We have
seen improvement in these numbers as well, but with a slower
change—as would be expected given the lower goal. We currently
are extrapolating the lessons learned at our clinic and
implementing them across other system sites. As a multi-specialty
health system, we now are focusing on ways to incorporate
what we have learned in a primary care setting and trying
to implement changes in specialty departments in which
the clinicians do not treat hypertension. The need for ease of
follow-up for patients is key. Given rising health care costs and
increases in patients’ deductibles and co-pays, providing an
easy-to-use nursing system that requires no payment from the
patient increases patient willingness to return to the clinic at
frequent intervals, which in turn results in quicker blood pressure
improvement. Use of nursing intervention to help with
blood pressure control is not a new model of care, but it is
a new model of care for our clinic. We have utilized nursing
staff to manage diabetes through diabetes nurse educators for
many years, but this had not been expanded to blood pressure
management before now.