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Table 5 Process and outcome measures used in Project ReD CHiP

From: A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol

Type

Measure+

Notes and definitions

Primary process measure

% with uncontrolled BP with medication titration in last 3 months

Uncontrolled BP ≥140/≥90 (or ≥130/≥80 if DM or chronic kidney disease); titration can be dose increase or medication change/addition

Secondary process measures

% with BP measure in EMR in last 12 months

 

% with history of pre-HTN with BP measure in last 12 months

Two clinic BPs ≥120-<140≥80-<90; not on HTN medication

% with HTN with measure in last 6 months

Two clinic BP ≥140/≥90 OR use of a HTN medication OR ICD9 diagnosis (401.xx)

% with HTN on a thiazide diuretic

 

% with HTN and DM on ACE-I or ARB

DM defined by ICD9 code 250.xx

% with lipid panel performed in last 5 years*

May not be possible as EMR only in all clinics since March 2006

% with BP≥135/≥85 screened for DM in last 5 years*

May not be possible as EMR only in all clinics since March 2006

Implementation uptake process measures

% with BP measured with OMRON

 

% of SBP and DBP measures ending in zero

 

% of eligible patients enrolled in care management

 

% completion rate for those enrolled in care management

 

Provider behavioral intention related to assessment and partnership skills

Measured at completion of the website review and at 6 months post-intervention

Change in provider self-reported use of assessment and partnership behaviors

Measured before the website review and at 6 months post-intervention

% of providers receiving web training at each site

Measured at 6 months post-intervention

Provider self-reported use of HTN dashboard

Measured at 6 months post-intervention

Primary outcome measure

% with controlled BP

Controlled BP defined as <140/<90 (or <130/<80 if DM or chronic kidney disease present)

Secondary outcome measures

% with controlled LDL

Controlled LDL defined as <130 (or <100 if DM or coronary artery disease)

% with controlled HDL

Controlled HDL defined as >50 in women or >40 in men

% with controlled triglycerides

Controlled triglycerides defined as <150

% with controlled A1C

Controlled A1C defined as <7.0

 

Mean SBP, DBP, LDL, HDL, triglycerides, A1C

 
  1. +Data are aggregated in one week intervals at baseline, during and after intervention roll-out for a minimum of 24 weeks.
  2. *These measures will only be performed in clinics that have had the EMR system in place for at least 5 years.
  3. Abbreviations: % percent, BP blood pressure, DM diabetes mellitus, EMR electronic medical record; HTN hypertension, ACE-I angiotensin converting enzyme inhibitor, ARB angiotensin receptor blocker, SBP systolic blood pressure, DBP diastolic blood pressure, LDL low density lipoprotein, HDL high density lipoprotein, A1C glycated hemoglobin.
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Implementation Science

ISSN: 1748-5908