Association for Utah Community Health

Success Story: Green River Medical Center

Issue:

Having high blood pressure (hypertension) increases a person’s risk for developing heart disease and stroke. However, a 12 to 13 point reduction in systolic blood pressure can reduce heart attacks by 21%, strokes by 37% and total cardiovascular deaths by 25%.

Utah’s frontier population, defined as counties with six persons or less per square mile, has high blood pressure and dies of heart disease at a rate that is 12% higher than the population of the state as a whole. The Green River Medical Center (GRMC), located along the border between the frontier counties of Emery and Grand, is the sole medical provider between Price and Moab, a distance of 115 miles. As one of the smaller community health centers in the U.S., the GRMC not only provides an essential health care access point for the region, but ensures that rural residents can also access quality, cost-effective health care through all life cycles. In July 2008, only 26% of their patients with hypertension had their blood pressure under control.

Intervention:

With funding from the Heart Disease and Stroke Prevention Program, through a contract with the Association for Utah Community Health (AUCH), GRMC was able to enhance its quality improvement efforts for care of patients with high blood pressure. A key component of these efforts included collecting blood pressure data, adding it to their PECS (Patient Electronic Care System) data base, and using this data to guide care decisions with patients, including appropriate follow-up. Interventions include:

·         Assisting patients to set self-management goals, and developing a process to improve accessibility of this information for providers

·         Providing low cost blood pressure monitors and a log for home monitoring

·         Educating patients in the proper use of their hypertensive medications and working to find medications that are suitable for patient needs

·         Working with pharmaceutical resources and service organizations to receive free and discounted medications for their patients

Impact:

In September 2008, GRMC set three goals as part of its contract with AUCH to improve care for cardiovascular patients. GRMC exceeded all three goals:

·         Increase the percent of all hypertensive patients with at least 2 blood pressure checks annually to 52.5%. As of June 2009, 64.8% of hypertensive patients had at least 2 blood pressure checks in the past year.

·         Increase the percent of all hypertensive patients with appropriate blood pressure control to 30%. As of June 2009, 58.4% of all hypertensive patients have appropriate blood pressure control.

·         Increase the percent of all hypertensive patients with smoking status documented in chart. As of June 2009, 36.8% of all hypertensive patients had their smoking status documented in their chart.