Table 4.

Examples of Most Engaging and Durable PDSAs (PDSAs) Activities by Key Driver Domain

Key DriverExample Activities
Clinical Information Systems (CIS)
  • Creating a practice level list and monthly reports of patients with HTN and uncontrolled HTN

  • Creating lists of hypertensive patients without recent visits or with uncontrolled HTN at their last visit for outreach

Standard Care Processes (SCP)
  • Instructing practice staff on guideline-concordant blood pressure measurements, including use of sound reduction equipment to provide a calm environment for patients during BP assessments and use of posters throughout the clinics demonstrating proper technique and engaging in refresher sessions to maintain focus on proper measurement technique

  • Working with staff to document BP in EHRs such that the data would populate HTN reports

  • Standardizing staff behaviors to repeat BP measurements for patients with SBP and DBP values ≥ 140 and/or ≥ 90 mm Hg

Optimized Team Care processes (OTC)
  • Holding group QI meetings with attendance where data review and improvement activities were devised

  • Creating HTN control educational videos for patients related to nutrition, lifestyle, and medication adherence

  • Weekly huddles to identify patients with uncontrolled BP and those requiring extra support; instituting processes for making follow-up phone calls to check on patient's engagement in their own care and reporting out of office BP measurements back to staff

  • Having all clinic staff wear different HTN control messages on their clothing such that a unique message is shared by each staff member who interacts with patients during visits.

Patient Self-Management Support (SMS)
  • Patients' use of BP log cards to document out-of-office BPs and instructing clinical staff on how to address noted BP trends that may be related to stress, lack of medication adherence, etc.

  • Use of refrigerator magnets to remind patients to check their BPs, know their goal BPs, and engage in healthy lifestyle activities

  • Use of “kudos” cards given to patients at subsequent office visits when BP's were improved

  • Use of “Teach Back” methods with patients

  • Engaging in patient goal setting activities

  • Providing a raffle in clinic waiting rooms to receive a home BP monitor as a way to promote home monitoring and self-management

  • BP, blood pressure; EHR, electronic health record; HTN, hypertension; SBP, systolic blood pressure; DBP, diastolic blood pressure; QI, quality improvement.