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Improving Blood Pressure Control in Evanston, IL: A Case Study

Northwestern Medicine™ Evanston instituted a self-measured blood pressure (SMBP) monitoring program. This practice assigned a medical assistant (MA) to manage the SMBP program. The physicians decided which patients would benefit from SMBP. The MA would then work with these patients. She received training on how to use SMBP monitors. She also learned how to educate patients about these monitors, including how to use them with proper body positioning, how often to take measurements based on a standardized office protocol, as well as how to read and record results.

Educational materials were created and provided to patients to teach them how to properly use the SMBP monitor. The materials included a reference flyer with a checklist to aid in proper technique and a SMBP flow sheet to track blood pressures (if the machine the patient was using did not have memory capabilities to store readings). The SMBP flow sheet also provided a written reminder of when to measure blood pressure. The MA was able to collect the results from the flow sheet without a physician visit. The SMBP results were averaged into a single systolic and diastolic blood pressure and recorded in the patient’s chart. The physician then reviewed the chart and adjusted the treatment, if necessary.

This program led to a 4 percent increase in control rates (percentage of patients treated to goal blood pressure (<140/90 mm Hg) in adult patients) over a 12-month period.

Key elements of success of the SMBP program included:

  • More accurate diagnosis and evaluation of hypertension management

  • If needed, ability to provide rapid treatment changes with active follow-up

  • Increased patient engagement in self-care of high blood pressure

  • Increased clinical teamwork and efficiency

  • Increased responsibility of MA, which allowed the practice to balance work load

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