The Hypertension CPG was published in 2020. To date, dissemination and implementation have occurred in 171 VA Medical Centers and 1298 healthcare facilities across the US. A range of training and resources are available to support the implementation of best practices for hypertension management. Hypertension is the leading cause of cardiovascular morbidity and mortality in the United States (US) and if untreated, can lead to complications including stroke, myocardial infarction, or peripheral arterial disease. Hypertension is a prevalent, preventable chronic disease among adults and Veterans. Clinical practice guidelines (CPGs) are evidence-based recommendations intended to optimize the care of patients with specific conditions. In 2020, the VA/DoD developed an evidence-based CPG for managing hypertension to improve clinical outcomes and healthcare quality. This poster presentation summarizes the process of implementing CPG best practices in the Department of Veterans Affairs, the largest healthcare system in the US.
Problem: CPGs provide the framework for best practice management of health conditions to optimize care. Despite their potential benefits, implementation of CPGs often faces challenges in adoption. Some of these challenges include lack of awareness, limited resources, lack of implementation tools, inconsistent application, and lack of monitoring and evaluation
Measurement: Data analysis was supported by the Office of Analytics and Performance Integration, affording the ability to provide enterprise-wide analytics to foster continuous quality improvement. Structural, process and patient-level outcomes were tracked utilizing standardized data reporting tools including the HEDIS measures for blood pressure control
Analysis: This project incorporated a variety of methodologies to serve as a structure for implementation including Lean Six Sigma and PDSA cycle, while working under the auspices of a High-Reliability Organizational framework. Screening and diagnosis, blood pressure control rate, use of guideline-recommended treatments, and adverse events related to hypertension were monitored
Implementation: We assessed current practices, involved key stakeholders, developed an implementation plan, provided a range of standardized training and resources, and monitored outcomes. Training sessions included webinars, written materials, and ongoing support and feedback. Hypertension CPG usage was nationally incorporated in Ongoing Professional Practice Evaluation at the site of care