Clinic Takes Team Approach to Controlling Hypertension in Ellsworth, Wisconsin

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.