A community-wide quality improvement initiative to improve hypertension control and reduce disparities.

摘要: Initiatives to improve hypertension control within academic medical centers and closed health systems have been extensively studied, but large community-wide quality improvement (QI) initiatives both less common successful in the United States. The authors examined a QI initiative across 226 843 patients from 198 practices nine counties upstate New York reduce disparities. focused on (a) providing population practice-level comparative data, (b) community engagement, especially underserved communities, (c) assistance, was not designed examine causality of specific components. Across counties, rates improved 61.9% 2011 69.5% 2016. Improvements were greatest among whites (73.7%-81.5%) more modest black (58.8%-64.7%). noted considerable BP group with highest risk (defined as ≥ 160/100) decrease disparities this group. collaborative identified five key lessons help guide future initiatives: anticipate plateauing response; distinguish needs disparate populations create subpopulation-specific strategies address disparities; recognize variation low SES practices; (d) remain open refinement outcome measures; (e) continually seek best barriers success. Overall, initiative, involving multiple different stakeholders, associated improvements reductions some targeted