Download or read book Measuring Quality of Care for Hypertension written by Christopher J. Hebert and published by . This book was released on 2008 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Home Blood Pressure Monitoring written by George S. Stergiou and published by Springer Nature. This book was released on 2019-10-31 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted. This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.
Download or read book A Population Based Policy and Systems Change Approach to Prevent and Control Hypertension written by Institute of Medicine and published by National Academies Press. This book was released on 2010-08-13 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines. The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.
Download or read book Utility of Blood Pressure Monitoring Outside of the Clinic Setting written by Lawrence J. Appel and published by . This book was released on 2002 with total page 301 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Quality of Care for Uncontrolled Hypertension Using a Novel Measure written by David St. Michel and published by . This book was released on 2008 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving the Quality of Care in Nursing Homes written by Institute of Medicine and published by National Academies Press. This book was released on 1986-02-01 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Download or read book Closing the Quality Gap a Critical Analysis of Quality Improvement Strategies Volume 3 Hypertension Care written by U. S. Department Human Services and published by Createspace Independent Publishing Platform. This book was released on 2013-06-07 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In early 2003, the Institute of Medicine (IOM) released its report, Priority Areas for National Action: Transforming Health Care Quality. The report listed 20 clinical topics for which "best practices" were strongly supported by clinical evidence. The report documents the disappointingly low rates at which these practices have been implemented in the U.S., at an annual cost of many thousands of lives. To bring data to bear on the quality improvement opportunities articulated in the IOM's 2003 report, the Agency for Healthcare Research and Quality (AHRQ) engaged the Stanford-UCSF Evidence-based Practice Center (EPC) to perform a critical analysis of the existing literature on quality improvement strategies for a selection of the 20 disease and practice priorities noted in the IOM Report. Rather than concentrating on the specific clinical practices that appear to improve health outcomes, the focus of this review is on translating research into practice-identifying those activities that increase the rate at which practices regarded as effective are applied to patient care in real world settings. This report focuses on the clinical problem of hypertension. It, like the other reports in the series, aims to help readers assess whether the evidence suggests that a quality improvement strategy would work in their specific practice or with their specific patient population. The question of whether these may be crosscutting practices-that is, the manner in which those that have been studied for specific conditions such as hypertension might be applicable to others, such as asthma-remains to be seen. We defined the quality gap as the difference between health care processes or outcomes observed in practice, and those potentially obtainable on the basis of current professional knowledge. We defined a quality improvement (QI) strategy as an intervention aimed at reducing the quality gap for a group of patients representative of those encountered in routine practice. Finally, a quality improvement target is an outcome, process, or structure that the QI strategy aims to influence, with the goal of reducing the quality gap. Examples of targets relevant to this volume include outcomes such as reductions in blood pressure, or processes such as improved provider adherence with medication choices in patients with hypertension. Despite the importance and prevalence of both diabetes and hypertension, and the richness of their clinical literatures, studies that would help patients, providers, and policymakers choose how best to close their quality gaps are somewhat confusing. For each entity, certain strategies (such as the use of multifaceted interventions, and perhaps disease management in diabetes, and the adoption of organizational change in hypertension) appear to be more effective than others. Yet, even in these areas, problems with publication bias, co-interventions, and secular trends make sweeping conclusions hazardous. Our review provides a huge collection of research data for the interested reader to dissect; undoubtedly, there is information that will be directly applicable to a given clinical situation or location. There are several important questions that warrant consideration in the realm of hypertension quality improvement. Some of these questions focus on prevention (screening) while others relate to the management of a chronic disease (blood pressure control). The reviewers have selected the following questions as important foci in the development of this report: Which QI strategies improve the process of screening for hypertension? Which QI strategies most effectively ensure that blood pressure goals are achieved and maintained? Which QI strategies improve provider adherence to recommended guidelines for hypertension management? Which QI strategies improve patient adherence to hypertension treatment?
Download or read book Diabetes and Hypertension written by Samy I. McFarlane and published by Springer Science & Business Media. This book was released on 2012-10-19 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.
Download or read book Self Measured Blood Pressure Monitoring Comparative Effectiveness written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-10 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. Untreated or ineffectively treated hypertension leads to increased cardiovascular morbidity and mortality, and increased consumption of health care resources, thus levying high human and financial costs to society. In adults, hypertension is defined as a persistently elevated BP equal to or greater than 140/90 mmHg. In children, the diagnosis is made from an average of three or more BP readings greater than the 95th percentile for age, sex, and height. The Seventh Joint National Committee (JNC 7) guideline recommends a BP goal of 140/90 mmHg or less in the general population and a lower threshold of 130/80 mmHg or less in patients with diabetes mellitus or chronic kidney disease. The World Health Report 2002 estimates that over 1 billion people have high BP and that hypertension is responsible for 4.5 percent of the global disease burden. Within the U.S., about 76.4 million adults are affected. Despite improvements in the quality of health care and life expectancy, it is expected that the prevalence of hypertension will continue to rise worldwide. The World Health Organization ranks high BP as the third highest risk factor for burden of disease, highlighting the contribution of hypertension directly and indirectly to the development of numerous diseases. Hypertension has been identified as a major risk factor for cardiovascular disease, and is an important modifiable risk factor for coronary artery disease, stroke, peripheral vascular disease, congestive heart failure, and chronic kidney disease. High BP directly results in 7 million deaths every year. Effective management of BP has been shown to dramatically decrease the incidence of stroke, heart attack, and heart failure. However, hypertension is usually a lifelong condition, and long-term adherence to lifestyle modification and medication treatment remains a challenge in the management of hypertension. Thus an increasing focus has been placed on developing strategies that can improve adherence and result in satisfactory BP control with the goal of improving health outcomes for hypertensive patients. One such proposed method is self-measured blood pressure (SMBP) monitoring. SMBP refers to the regular self-measurement of a patient's BP at home or elsewhere outside the office or clinic setting. However, while patient self-participation in chronic disease management appears promising, the sustainability and clinical impact of this strategy remain uncertain. The primary objective of this review is to evaluate whether the use of SMBP monitoring influences outcomes in adults and children with hypertension, and to what extent these changes in outcomes can be attributable to the use of self-monitoring devices alone or the use of SMBP plus additional support or attention. The intention of this report is to inform physicians' decisionmaking as to whether to encourage the use of SMBP monitoring alone or along with additional support, and to assist health care policymakers and payers with decisions regarding coverage and promotion of SMBP monitoring. Key Questions include: 1. In people with hypertension (adults and children), does self-measured blood pressure (SMBP) monitoring, compared with usual care or other interventions without SMBP, have an effect on clinically important outcomes? 2. In trials of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? 3. How do different devices for SMBP monitoring compare with each other (specifically semiautomatic or automatic vs. manual) in their effects on clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence)? 4. In trials of SMBP monitoring, how does achieving BP control relate to clinical and surrogate outcomes? 5. How does adherence with SMBP monitoring vary by patient factors?
Download or read book Conceptualization and Measurement of Physiologic Health for Adults written by Robert H. Brook and published by . This book was released on with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is the condition of chronically elevated blood pressure. Data on its prevalence and adverse consequences are used in the Health Insurance Study (HIS) to investigate the effect of different levels of insurance on health status and quality of care for three main reasons: widespread prevalence, association with considerable morbidity and mortality, and amenability to treatment and control. This volume reviews pertinent medical literature, details the HIS definition of hypertension, describes HIS methods for measuring its presence and impact on people's lives, presents and discusses the enrollment data of the six HIS sites, and outlines quality-of-care criteria. Illustrative findings include the following: Nearly 12 percent of about 3320 HIS adult enrollees were classified as hypertensive by actual blood pressure measurement. Of those with definite hypertension, about two-thirds knew they had the condition and, of this latter subgroup, 57 percent reported they worried about the illness and 17 percent restricted their usual activities.
Download or read book Understanding Healthcare Delivery Science written by Michael Howell and published by McGraw Hill Professional. This book was released on 2019-09-27 with total page 480 pages. Available in PDF, EPUB and Kindle. Book excerpt: A new title in the acclaimed Understanding series that focuses on the science of healthcare delivery Over the past decade, the subject of Systems Science has skyrocketed in importance in the healthcare field. With its engaging, clinically relevant style, Understanding Healthcare Delivery Science is the perfect introduction to this timely topic. It covers every aspect of what actually constitutes “best care” and how it can be most efficiently delivered from an operational standpoint. The book is exceptional for two other reasons: numerous case vignettes put the content in a clinically relevant framework, and its comprehensive coverage spans everything from quality and safety to data and policy. Readers will find a valuable opening section that delivers an outstanding introductory discussion of Healthcare Delivery Science Co-author Dr. Michael Howell is a nationally recognized expert on healthcare quality, whose research has been covered by The New York Times, CNN, and Consumer Reports. He has served on national quality- and safety-related national advisory panels for the CDC, Society of Critical Care Medicine, CMS, and others. An active healthcare delivery scientist, Dr. Howell has published more than 90 research articles, editorials, and book chapters on topics related to quality, safety, patient-centeredness, and critical care.
Download or read book Hypertension Care written by and published by . This book was released on 2005 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: Hypertension affects more than 50 million people in the United States alone. Despite clear evidence regarding the beneficial effects of quality treatment for high blood pressure, many millions of diagnosed and undiagnosed hypertensives are not receiving the optimal standard of care. The difference in patient outcomes achieved with present hypertension treatment methods and those thought to be possible using best practice treatment methods is known as a quality gap, and such gaps are at least partly responsible for the loss of thousands of lives each year. This review was organized to bring a systematic assessment of different quality improvement (QI) strategies and their effects to the process of identifying and managing hypertension. SEARCH STRATEGY AND INCLUSION CRITERIA: Investigators searched the MEDLINE® database, the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) registry, article bibliographies, and relevant journals for experimental evaluations of QI interventions aimed at improving hypertension screening and management of non-pregnant adults with primary hypertension. The reviewers included randomized or quasi-randomized controlled trials, controlled before/after studies, and interrupted time series in which at least one reported outcome measure included changes in blood pressure, or provider or patient adherence to a recommended process of care. DATA COLLECTION AND ANALYSIS: Relevant data were abstracted independently by two reviewers. Each QI intervention was classified into one or more of the following components: provider education, provider reminders, facilitated relay of clinical information, patient education, promotion of self-management, patient reminders, audit and feedback, organizational change, or financial incentives. Certain categories were further subdivided into major subtypes (e.g., professional meetings for provider education and disease management for organizational change). The researchers also evaluated the impact of clinical information systems as a mediator for interventions of all types. They compared the different QI strategies in terms of the median effects achieved for blood pressure control and for a generalized measure of provider or patient adherence. MAIN RESULTS: Sixty-three articles reporting a total of 82 comparisons met the inclusion criteria. Studies of hypertension identification were found to be too heterogeneous for quantitative analysis. The majority of screening studies were clinic-based (with a few offered at work sites), and the most common strategies involved patient and/or provider reminders. These generally showed positive results; several studies found that patients were more likely to know their blood pressure or attend clinic visits after receiving reminders. Across all studies with a variety of strategies, the median reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 4.5 mmHg (interquartile range: 1.5, 11.0) and 2.1 mmHg (interquartile range: -0.2, 5.0), respectively. The median increase in the proportion of patients in the target SBP range and target DBP range was 16.2 percent (interquartile range: 10.3, 32.2), and 6.0 percent (interquartile range: 1.5, 17.5), respectively. Studies that focused on improving provider adherence showed a range of median reduction of 1.3 percent to a median improvement of 3.3 percent across all QI strategies. Overall, patient adherence showed a median improvement of 2.8 percent (interquartile range: 1.9, 3.0). CONCLUSION: The findings of this review suggest that QI strategies appear, in general, to be associated with the improved identification and control of hypertension. [Authors].
Download or read book Disease Control Priorities in Developing Countries written by Dean T. Jamison and published by World Bank Publications. This book was released on 2006-04-02 with total page 1449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Download or read book Self Measured Blood Pressure Future Research Needs written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-05-23 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is a common, long-term health condition, particularly prevalent among older adults. Untreated or undertreated hypertension leads to increased cardiovascular morbidity and mortality, as well as increased consumption of health care resources; however, long-term adherence to lifestyle modification and medication remains a challenge. Self-measured blood pressure monitoring (SMBP) has been suggested as one method that may improve adherence to blood pressure (BP) treatment and consequently improve outcomes. SMBP refers to the regular self-measurement of a patient's BP at home or otherwise outside the office or clinic, as a supplement or alternative to those obtained in a health care setting. While patient self participation in chronic disease management appears to be a promising means of improving adherence, the sustainability and clinical effect of this strategy, as well as its impact on health care utilization, remain uncertain. The current Future Research Needs (FRN) project was launched upon the completion of an Agency for Healthcare Research and Quality (AHRQ) Comparative Effectiveness Review (CER) on SMBP, and builds on the evidence gaps identified in that review. The present report describes the development of a stakeholder-prioritized list of research needs for that topic, along with a measured consideration of the advantages and disadvantages of various potential research designs, in order to help researchers and funders develop future research proposals or solicitations. This report identifies five high-priority future research needs with regards to SMBP, as determined by a stakeholder panel. They are: 1. What are the effects of SMBP on BP, medication adherence rates, satisfaction, and clinical event outcomes, after longer followup periods of 2 to 5 years or longer? 2. Which patients may be more likely to benefit from using SMBP? 3. What is the best prescription or protocol for SMBP (when, how often, and how frequently)? How do different prescriptions for SMBP compare regarding acceptance by patients, adherence with SMBP, and effect on BP control? 4. What is the role of additional support? What particular components of additional support should be further evaluated? 5. What is the effect of SMBP on resource utilization? What is the cost-effectiveness of SMBP?
Download or read book Toward Quality Measures for Population Health and the Leading Health Indicators written by Institute of Medicine and published by National Academies Press. This book was released on 2013-10-04 with total page 135 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine (IOM) Committee on Quality Measures for the Healthy People Leading Health Indicators was charged by the Office of the Assistant Secretary for Health to identify measures of quality for the 12 Leading Health Indicator (LHI) topics and 26 Leading Health Indicators in Healthy People 2020 (HP2020), the current version of the Department of Health and Human Services (HHS) 10-year agenda for improving the nation's health. The scope of work for this project is to use the nine aims for improvement of quality in public health (population-centered, equitable, proactive, health promoting, risk reducing, vigilant, transparent, effective, and efficient) as a framework to identify quality measures for the Healthy People Leading Health Indicators (LHIs). The committee reviewed existing literature on the 12 LHI topics and the 26 Leading Health Indicators. Quality measures for the LHIs that are aligned with the nine aims for improvement of quality in public health will be identified. When appropriate, alignments with the six Priority Areas for Improvement of Quality in Public Health will be noted in the Committee's report. Toward Quality Measures for Population Health and the Leading Health Indicators also address data reporting and analytical capacities that must be available to capture the measures and for demonstrating the value of the measures to improving population health. Toward Quality Measures for Population Health and the Leading Health Indicators provides recommendations for how the measures can be used across sectors of the public health and health care systems. The six priority areas (also known as drivers) are population health metrics and information technology; evidence-based practices, research, and evaluation; systems thinking; sustainability and stewardship; policy; and workforce and education.
Download or read book The Quality of Medical Care written by United States. Congress. Office of Technology Assessment and published by DIANE Publishing. This book was released on 1988 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt:
