The Ohio State University

Introduction

The Regional Quality Improvement (QI) Hub at The Ohio State University is working in collaboration with state and academic partners to create a QI training system housed within the OSU College of Medicine. The initiative seeks to support QI operational infrastructure within the OSU system and in the Central Ohio region. OSU works in collaboration with primary care sites, managed care organizations, community partners, and patients with the goal of improving health outcomes for adult patients. The first project focuses on hypertension with the goal of expanding to additional chronic disease diagnoses in the future. https://u.osu.edu/qihubresources/

Focus Areas

Our current focus area is hypertension (HTN) control in primary care. High blood pressure is a leading cause of stroke, heart disease, and other adverse health conditions. Our team is prioritizing the following structural and process based key drivers that impact patient outcomes:

• Accurate and Repeated Blood Pressure (BP) Measurements
  • Our team endorses interventions such as ensuring proper technique for the initial BP measurement as well as an established process to ensure a consistent recheck of the BP. We also support the use of the standardized American Heart Association (AHA) criteria for the diagnosis of HTN.
• Standardized American Heart Association Guided Treatment Escalation
  • The AHA, in conjunction with the American College of Cardiology, has established HTN guidelines for clinical practice. These guidelines include the standardized identification of patients with HTN, implementation of evidence-based first line medication regimes, and processes to titrate the treatment regime until the desired goal is achieved. Additionally, we endorse the use of home BP monitoring with patient centered action plans.
• Timely, Goal Directed Follow-up Using a Team Based Approach
  • With the awareness that clinical access is frequently limited, our team endorses a multidisciplinary approach to individualized care. For patients with high BP or those who have received a diagnosis of HTN, a consistent schedule of timely follow-ups within 35 days between healthcare visits is an important intervention. The multidisciplinary team should include the collaborative integration of clinical pharmacists as well as nursing and medical assistant HTN visits.
• Operational Alignment Through Data Support, Policy Evaluation, and Performance Standards
  • Operational interventions at the system level of the organization are encouraged to ensure that data support is available to the primary care locations for active monitoring of specific HTN processes. Additionally, standardized work should be formally documented as part of clinic policies and clinician performance criteria.

In addition to primary care clinic activities, our team is actively engaging community organizations and patients in our work. We are partnering with the OSUWMC Healthy Community Center to support their healthy lifestyle events along with providing health education resources. We have also partnered with the Columbus Metropolitan Libraries to provide health education materials at their 24 locations within 23 communities throughout Central Ohio. To ensure our work is patient centered and our educational materials are accessible, we routinely conduct phone interviews to obtain patient perspectives and feedback.