Improving hypertension control in diabetes: a multisite quality improvement project that applies a 3-step care bundle to a chronic disease care model for diabetes with hypertension

Am J Med Qual. 2013 Sep-Oct;28(5):365-73. doi: 10.1177/1062860612469683. Epub 2013 Jan 11.

Abstract

Hypertension in diabetes patients leads to significant morbidity and mortality. Nonetheless blood pressure (BP) control in patients with diabetes remains disappointing. The authors applied a care bundle to decrease the proportion of patients with BP exceeding 130/80. Teams from 4 sites in 3 states (Minnesota, Florida, and Arizona) developed a bundle consisting of a standardized BP process, an order set, and a patient goal. Baseline data were collected in the first 12 weeks, followed by 6 weeks of implementing changes. The final 16 weeks represented the intervention. There was a statistically significant decrease in the proportion of patients with uncontrolled BP in 3 of 4 sites (P < .0001 in all 3 sites demonstrating improvement). There was a statistically significant improvement in the satisfaction survey (P = .0011). Implementing an evidence-based care bundle for hypertension in diabetes mellitus can improve BP outcomes.

Keywords: care bundle; diabetes; hypertension; quality project.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Pressure
  • Diabetes Complications / therapy*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Humans
  • Hypertension / etiology
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Models, Organizational
  • Patient Care Bundles / methods*
  • Patient Satisfaction
  • Quality Improvement / organization & administration*
  • Quality Indicators, Health Care
  • Young Adult