2014 Million Hearts Hypertension Control Challenge Champion - P.S. Rudie Clinic, Duluth, Minnesota - Small practice

Speaker: Craig L. Gilbertson, MD, Family Practitioner, P.S. Rudie Clinic, Duluth, Minnesota.

Date: June 19, 2015

Listen to the presentation here. (23 minutes)


Objectives of the Presentation: 

  • Describe the problem with hypertension control in the P.S. Rudie Clinic population
  • Describe the planning process to identify hypertension control strategies
  • Describe the key successes and challenges to implement strategies for hypertension control
  • Describe the results achieved through the implementation of strategies

Main points to be covered:

  •  How P.S. Rudie Clinic achieved hypertension control rates above 80%.

Main points presented:

  • P.S. Rudie clinic was an independent multi-specialty practice until 2007 when it merged with St. Lukes. It has 9 providers.
  • The hypertension control rates have been moved from 73% to 86%, and they have been able to maintain close to that rate since achieving it in 2014.
  • They worked with the local quad-community health board to promote wellness, focusing on tobacco cessation, obesity reduction and hypertension control.
  • Ten specific points helped them maintain their levels:
    • They are an established small group practice for 70-80 years which allows patients to have continuity of care within a consistent medical home.
    • Providers use a team-based approach from the receptionist to the physicians. All are involved an important in the practice.
    • There is a loyal patient population resulting in a more compliant patient population.
    • The environment promotes wellness and includes quality improvement initiatives. This was helped through a grant with the local quad-community health board which allowed them to stimulate awareness of high blood pressure in the community.
    • Providers and patients share goals of treatment – patients are included in the conversation about their health status and steps to take to improve their health.
    • Prescription refills are monitored to ensure patients are in compliance with the medication therapy management.
    • Follow-up appointments are scheduled at the time of the visit.
    • Staff receive training on accurate blood pressure measurement techniques, and files are flagged to show patients with HBP. Red lettering in files or magnetic chips placed on the exam door are used to ID a person with HBP and ensure follow-up is conducted.
    • Blood pressure cuffs are provided to patients to use outside the office. This assists with the white coat affect that can occur with HBP.
    • Providers are caring, involved, conscientious, and vigilant about managing and caring for patients. People respond to people who care, causing better compliance.

Main take-away points:

  • Acquiring trust with patients by caring for their well-being is a key motivator to compliance.
  • Stay updated and educate staff on proper goals and management techniques of HBP.
  • Establish a team-based approach, assuring that all staff know their importance in the care and management process.
  • Use electronic health records to track and flag patients with HBP.
  • Work with the local public health board to collaborate on population-based strategies and heighten the sense of awareness of HBP in the community.
  • There must be a medical home for patients that they trust and are comfortable in and is reasonable and cost effective so that patients will use to help them manage their high blood pressure.