Through a new, collaborative change in treatment processes and support from the community, the number of Summit Community Care Clinic patients diagnosed with hypertension who have been able to control their blood pressure has increased. 

As part of the Care Clinic’s ongoing Quality Assurance and Improvement program, blood pressure control is one of several metrics monitored and used to determine the efficacy of the Care Clinic’s treatments, processes, and programs. Tracking back to 2017, the number of Care Clinic hypertension patients whose blood pressure was adequately controlled (blood pressure readings below 140/90) hovered around 60%. This matched the US national average of 58% but was below the 70% target based on the mean performance of other Colorado Community Health centers.

High, uncontrolled blood pressure increases the risk of heart attacks, strokes, aneurysms, kidney problems, and more. As blood pressure tends to run higher for those living at elevation, controlling blood pressure among the Care Clinic’s patients, most of whom live in mountain communities, is more challenging. 

“Much of blood pressure management really depends on patients understanding their condition. Hypertension is known as the ‘silent killer,’ as most people feel fine with elevated blood pressure. It requires a good relationship with a medical provider to understand why treating this is so important,” stated Dr. Kathleen Cowie, MD, Chief Medical Officer at the Care Clinic. 

The steady numbers prompted a new, team-based approach, implemented in July 2022, using the Care Clinic’s Model for Improvement. This included:

• Training and re-training of Medical Assistants in proper blood pressure measurement;
• Purchasing electronic blood pressure cuffs for each exam room to facilitate a more efficient check-in process;
• Validating initial high readings, as many patients can initially have elevated pressures due to the stress of arriving in a clinical environment.
• Providing additional training for medical providers on hypertension management best practices and case reviews;
• The addition of the on-site Pharmacy in September 2022, which made obtaining medications much easier for many patients;
• Development of patient educational materials at appropriate reading levels in English and Spanish;
• Patient engagement through referrals to the Care Clinic’s in-house health coaching and tobacco cessation programs to initiate beneficial lifestyle changes;
• Distribution of blood pressure cuffs to patients for at-home monitoring and;
• Follow-up protocols to facilitate compliance 

As a result of these new processes, the Care Clinic saw an increase in the number of patients who are successfully managing their blood pressure. As of August 2023, the blood pressure control measure was 71.8%, exceeding the 70% target.

“We continuously strive to improve the quality of care to support the improvement of patient safety and health outcomes. I am so proud of the collaboration between and within our medical teams to ensure what we are doing is working – from added communication between staff to really empowering our patients to manage their care, fewer people are having strokes and heart attacks because of these changes,” said Dr. Cowie. 

The updated and expanded blood pressure control initiatives at the Care Clinic are supported by our federal, state, and local partners, including Health Resources & Services Administration (HRSA), Colorado Department of Health and Environment (CDPHE), and the Rotary Club of Summit County.