Assignment: Healthcare Program/Policy Evaluation Analysis Template

Hypertension Management Program (HMP) in a Federally Qualified Health Center (FQHC).

The HMP used a team-based, patient-centered approach that relied on the contributions of clinical pharmacists to better manage hypertension patients.

It consisted of 10 components:

1. An integrated care team
2. EHR patient registries and outreach lists
3. No copayment walk-in blood pressure checks
4. EHR alerts for blood pressure re-checks
5. Education for nurses and other staff on appropriate blood pressure measurement technique
6. Promoting the use of combination medications to treat high blood pressure
7. Hypertension management visits (HMVs)
8. Promotion of home blood pressure monitoring
9. Specialty department blood pressure measurements with referral to primary care when needed
10. Incentives, rewards, and recognition for members of the care team.

• The success of the HMP was measured using a pre/post evaluation design, which estimated the relation of HMP with hypertension control rates and systolic blood pressure using electronic health record data (Lowe Beasley et al., 2023).

• The program was implemented HMP in seven clinics of a Federally Qualified Health Center in rural South Carolina, Family Health Centers.
• The program reached 3,941 patients with a diagnosis of hypertension.
• The program helped hypertensive patients control their blood pressure at optimal levels.
• In the pre-intervention period, 53.4% of patients had controlled hypertension, while in the implementation period, 57.3% had controlled hypertension (Lowe Beasley et al., 2023).

• The program evaluation was conducted after a 15-months- implementation period.
• The program was implemented from September 2018 to December 2019 (Lowe Beasley et al., 2023).

EHR data was collected from September 1, 2016, to September 4, 2018 (pre-intervention period), and from September 5, 2018, to December 31, 2019 (intervention period) (Lowe Beasley et al., 2023).

The data included patients who had:

1. Three or more visits to FHC
2. At least one visit in both the pre-intervention and intervention periods
3. Aged 18 to 85 years old with a diagnosis of hypertension in the pre-period
4. Had no diagnosis of end-stage renal disease, transplant, or pregnancy.

The stakeholders identified in the program evaluation include patients, clinical pharmacists, the Associate Director of Pharmacy, nurses, and Information technology (IT) staff.

–       Patients were major stakeholders since they were the primary focus of the program.

–       Clinical pharmacists: They conducted outreach to patients with uncontrolled hypertension; Developed and executed medication management plans during HMVs (Lowe Beasley et al., 2023).

–       Associate Director of Pharmacy: Led the Hypertension Coaching program in place before HMP and took over the champion role.

–       Nurses: Performed no-copayment blood pressure checks to patients who met the specified criteria.

–       IT staff programmed an alert to pop up in FHC’s EHR once the nurse entered an elevated BP reading (Lowe Beasley et al., 2023).

• Patients with hypertension would benefit the most from the results and reporting of the HMP.
• This is because the positive results would drive other healthcare facilities to adopt a similar program, which would improve their BP control and prevent complications from sustained high BPs.
• Patients who participated in the HMP benefited from hypertension control and improved SBP during the program .

·         The original aim of the Hypertension management program was to improve hypertension control and address health disparities (Lowe Beasley et al., 2023).

·         The program met its intended purpose based on the results of an improved patient population that achieved controlled hypertension from 53.4% to 57.3%. The results showed a statistically significant increase in hypertension control rates in six of the seven clinics. Besides, the likelihood of controlled hypertension was 1.21 times higher during the intervention period than the pre-intervention (Lowe Beasley et al., 2023).

·         There was an improved control of BP in Blacks who are disproportionally affected by Hypertension, which proves the program met its goal.

·         The evaluation provides evidence for the effectiveness of the Hypertension Management Program approach in an FQHC system that serves Black/African American patients with high rates of comorbidity, and in a geographic region that has some of the highest rates of hypertension diagnosis (Rodis et al., 2019).

·         Consequently, I would recommend a similar program at my place of work since implementing HMP at FQHCs has the potential to deal with disparities in health outcomes among minority racial/ethnic groups facing a disproportionate impact of cardiovascular diseases.

The nurse advocate can participate in a policy or program evaluation after implementation through:

·         Interviews: The nurse can perform open-ended and semi-structured interviews with the program’s participants to obtain their views about the program. The nurse can ask the stakeholders how they have benefited, challenges encountered, and areas of improvement.

·         Focus groups: The nurse can hold discussions using focus groups to obtain information about the strengths and areas of improvement of the specific program activity (Milstead & Short, 2019).

• Findings from the program evaluation can inform the replication of Hypertension management programs in similar healthcare settings, which play a primary role in caring for patients with health and socioeconomic disparities.