Clinic Takes Team Approach to Controlling Hypertension in Ellsworth, Wisconsin
Almost 800,000 Americans die of cardiovascular disease each year.
Less than half of the 67 million American adults with high blood pressure have the condition adequately controlled.
The Ellsworth Medical Clinic implemented a patient-centered team approach to deliver the best care.
Blood pressure control was achieved for 97% of Ellsworth Clinic patients with cardiovascular disease or diabetes.
Currently, about 67 million American adults have high blood pressure and less than half (46%) have it adequately controlled. High blood pressure is one of the leading causes of heart disease and stroke. Of the 800,000 deaths in the United States each year from cardiovascular disease, 600,000 are from heart disease and 130,000 are from stroke. While heart disease and stroke can be fatal, they can also result in serious illness, disability, and decreased quality of life. Further, hypertension and its associated diseases pose $156 billion in medical and lost productivity costs each year.
The national Million Hearts™External initiative aims to prevent 1 million heart attacks and strokes by 2017. Achieving this goal means that 10 million more Americans must have their blood pressure under control. Million Hearts™ is working to reach this goal through clinical approaches, such as using health information technology to its fullest potential and integrating team-based approaches to care, as well as community approaches, such as strengthening tobacco control, reducing smoking, and improving nutrition through decreased sodium and artificial transfat consumption.
Doctors, nurses, pharmacists, and community health workers play a key role in helping Americans control their blood pressure. They provide high-quality clinical care and encourage patients to make healthy lifestyle changes.
Million Hearts™ partner Ellsworth Medical Clinic in Ellsworth, Wisconsin, has achieved exemplary rates of blood pressure control using patient-oriented methods and a team approach. The clinic, which provides primary care in a rural community of approximately 1,500 residents, has two primary care physicians, a certified physician assistant, a registered and certified dietitian, a care coordinator, and office support staff. Each member of the team plays a specific and important role to help patients control high blood pressure, thus reducing the impact of heart disease and stroke in the Ellsworth community.
Ellsworth Medical Clinic employed the following protocols to promote blood pressure control among its patients:
- Clinical support staff members now review each chart before patients arrive for an office visit to ensure the patient’s care and tests are up to date.
- The laboratory technician double checks guidelines to make sure all appropriate tests are ordered.
- Staff members place a magnet outside the exam room door for each patient with a blood pressure reading above 140/90. The magnet alerts the physician that this health concern needs attention.
- New chronic disease management guidelines empower all clinical staff members to order necessary lab tests at any visit.
- Visit summaries and follow up guidance are communicated verbally and printed for the patient at the end of each visit.
- Return-to-clinic reminders are placed in the electronic health record and tracked by front office staff so patients can be contacted and reminded to follow up on lab or clinic visits as they become due.
- All staff members encourage patients to drop in to the clinic anytime for blood pressure checks.
- The care coordinator follows up with patients between visits to check medication adjustments and to schedule additional clinic appointments.
In June 2012, Ellsworth’s primary care providers reported a control rate of 87% for all hypertensive patients.
Minnesota Community Measurement, a collaboration of health care organizations and professionals dedicated to improving the quality of care, recognized Ellsworth Medical Clinic as a top performer among 433 clinics in providing care for diabetes and vascular diseases. In just four years, Ellsworth Medical Clinic reported the following improvements in blood pressure control:
- Among patients with diabetes, hypertension control increased from 73% to 97% (2007–2011).
- Among patients with cardiovascular disease, hypertension control increased from 68% to 97% (2007–2011).
Ellsworth Medical Clinic achieved this success by involving the entire staff in patient care, empowering the staff to follow chronic disease guidelines, having standing lab orders, and using low-tech methods (such as door magnets) to cue physicians that blood pressure is a concern for the patient. Lessons learned included
- It takes a patient-centered team approach to deliver the best care.
- Patients do best when they are involved in their care and receive consistent messages from all those contributing to their care.
- The electronic medical record is a great tool to manage data—and care—if used appropriately.
Publication date: 09/11/2012
For story information, contact
Christopher Tashjian, MD, FAAFP
President, River Falls, Ellsworth, and Spring Valley Medical Clinics
The information in Public Health Practice Stories from the Field was provided by organizations external to CDC. Provision of this information by CDC is for informational purposes only and does not constitute an endorsement or recommendation by the US government or CDC.