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Improving Blood Pressure Control in Individuals with Diabetes: A Quality Improvement Collaborative

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Background: Studies show that it is difficult to achieve blood pressure (BP) targets among people with diabetes. Methods to improve BP control are needed. A quality improvement (QI) collaborative was established to improve systolic BP (SBP) control in persons with diabetes.

Methods: A longitudinal study with a three-phase QI collaborative as the intervention was conducted with 51 primary care practices within 12 health care organizations in the United States. Baseline, 6-, and 12-month posteducation performance data were collected. Phase 1 began in October 2006, and all sites completed all three phases by June 2008. Sites participated on four collaborative conference calls to discuss shared data and individual site activities, as well as on monthly calls with their project consultant. Some 624 staff participated in interactive education programs, and data were collected on 11,510 patients with diabetes.

Findings: All site champions stated that the collaborative supported process changes and engaged stakeholders and patients, focused staff on accurate BP measurement and treatment options, and served to identify and address gaps in outcomes. Mean SBP significantly improved from baseline (130.4 mmHg) to 6 months (127.4 mmHg; p < .001) and to 12 months (128.6 mmHg; p < .001). The proportion of patients with SBP < 130 mmHg increased from baseline (47.3%) to 6 months (56.4%; p < .001) and to 12 months (53.1%; p < .001). The proportion of patients with BP < 130/80 mmHg increased from baseline (36.8%) to 6 months (45.1%; p < .001) and to 12 months (42.2%; p < .001).

Conclusions: A QI collaborative that provides focus, structure, and strategies to help health care organizations customize and standardize processes related to BP management can improve BP control in patients with diabetes.

Document Type: Research Article

Publication date: March 1, 2011

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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