AUGUST 2015 VOL 5 HYPERTENSION IN THE NEWS

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HYPERTENSION ADVISORY GROUP,

UP-COMING CONFERENCES

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GROUP MEDICAL APPOINTMENTS,

PRACTICE REPORTS

PAGE ............................ 4 bp monitor A/HMP news

Hypertension in the News! CBC News: A new study says

treating high blood pressure eats

up roughly 10 per cent of Canada's

health-care budget, and those

costs are growing. Researchers

says historic trends show that if

nothing is done it could cost Cana-

dian taxpayers more than $20 bil-

lion by 2020. In 2010 alone, the

federal government spent

$13.9 billion treating the symptoms

and consequences of hypertension.

The research comes from the

University of Calgary's Cumming

School of Medicine, and was pub-

lished in the July 2015 Hyperten-

sion medical journal. It says nine

out of 10 people will develop the

condition during their lives.

Dr. Norm Campbell says the good

news is high blood pressure is often

preventable. He says there are two

paths: a public health approach of

promoting a healthy lifestyle and

identifying people with hyperten-

sion and making sure they are

properly treated.

L ooking within HMP: A 2009

Heart & Stroke Foundation

Study, showed 15% of On-

tario patients with hypertension

were treated but uncontrolled. At

June 2015, the HMP shows 42.3% of

enrolled HTN patients’ last BP read-

ing was at or below 140/90, proving

again that the Hypertension Man-

agement Program, funded by the

Ministry of Health and Long Term

Care, continues to support diagnosis

and treatment of hypertension.

PARTICIPATION AGREEMENTS,

PERSPECTIVE ON PROGRAM VITALITY

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New Participation Agreements: TECH TIPS

<30 Days is a

free app

designed by

the Heart &

Stroke Foun-

dation that

allows iOS

users to

complete a mini-risk assess-

ment, then presents them with

daily challenges to support be-

haviour modification on their

top 3 identified risk fac-

tors...healthy technology!

Launched in 2012, with more

than 125,000 downloads to

date, <30 Days use has far ex-

ceeded targets.

A re-designed app is expected

this fall, boasting new features

like:

compatibility with Android

more challenges

new step counting feature

ability to share through

Facebook and Twitter!

Get it from the iStore

Has your site already submitted the new Participation Agreement?

This agreement replaces the consents that individual HCPs had to use

to join the program. By working with your HMP Outreach Specialist to

submit the new site level Participation Agreement, your whole site is

covered by a single document, meaning your site can add new HCPs

without extra forms each time. How efficient!

On a recent flight to Windsor Ontario

to set up a new NP Led Clinic HMP site in Belle River, a bird’s eye view of the scenery gave me reason to think about the HMP program and how it helps to take a look at the big picture.

Any program is like a river: at inception there is lots of energy and a fast pace, cutting a deep path as the initiatives become embedded into the framework of the practice. As things move forward the pace naturally slows but still follows a direct path to meet clinical targets and provide optimal care for patients.

With incoming staff joining an HMP site, like tributaries entering a river, we see new energy and momen-tum that carves a deeper wider path of activity covering a greater area, growth of the program initiative.

As time goes by the path may meander, energy may diverted to oth-er program areas needing attention, changes in leadership, transitioning to a new EMR and staff turnover or loss of key program team members can cause a loss of direction and we may lose site of the ‘big picture’.

Taking Stock: With the HMP, your ready made Practice Reports con-tinue to reflect the enrollment of pa-tients and results of your combined inter-disciplinary efforts, often provid-ing information on additional opportu-nities for management of BP and oth-er chronic diseases, a constant re-minder of the health of your program.

In the December 2014 edition of this Newsletter [available on our web page] we profiled our website tools, created in response to your re-quests, that can orient new staff, keep staff educated and support them in delivering this ministry funded model of best practice for the management of hypertensive patients.

Need more help to infuse vital-ity back into your program, review the ‘big picture’ ?. The HMP team’s Out-reach Specialists are also available to help revitalize your program. We can customize a visit to address your spe-cific circumstances, re-engage team members, set progress goals and align information and resources for optimal program health! Contact your Outreach Specialist for more information, and set in motion your Program Infusion Plan!.

PROGRAM VITALITY— HMP Outreach Specialist Sarah Winterton shares a different perspective

HEALTHY TECHNOLOGY?

Use Stats 1st 6 Months available

Downloads 69952

Completed Assessment

57,330 (82%)

Complete a challenge

42,223 (60%)

Complete 2-14 challenges

32,104 (46%)

Complete 15-21 challenges

8,968 (13%)

Complete 30 challenges

4,968 (7%)

NEWS & EDUCATIONAL OPPORTUNITIES

**NEW** Waist Measurement cards are

available from our website, with updated risk

measures by gender

**NEW** The 2015 CHEP Guidelines are now

available from our website or from

www.hypertension.ca.

What it is: The Hypertension Advisory Group is a group of multi-disciplinary profes-sionals, including nurses, nurse practitioners, physicians, executive directors/program managers and other allied health professionals, coming from sites en-gaged with the Hypertension Management Program (HMP).

Their purpose: provide feedback, guidance and advice to the HMP Team regarding development, implementation, resources and operation of the program within pri-mary care settings across the province.

Their goals: contributing to an effective outreach and site support strategy, sharing knowledge, experiences, and successful strategies, provide ongoing feedback and recommendations regarding program operation & resources, to assist in identifying healthcare team learning needs, priorities and methods of delivery to support HMP in clinical practice.

How it works: The advisory group typically meets twice a year, and is supported administratively by an Outreach Special-ist from the HMP.

PROFESSIONAL DEVELOPMENT Come visit us at these upcoming conferences!

Hypertension Canada hosts its 5th annual Canadian Hypertension Congress. The

Canadian Hypertension Congress gathers key opinion leaders & faculty, showcasing the

latest research in hypertension, designed specifically to enable the development and

exchange of evidence-based information on the pathobiology and management of hy-

pertension.

Primary Care Track: programing on Friday Oct 23 - A one day only registration, ide-

al for Nurses, Nurse Practitioners, Pharmacists, Family Health Teams and GP's who

can only get away for the one day. For info visit: hypertension.ca/en/chc Registra-

tion Now Open!

Hypertension Advisory Group: CALL FOR NEW MEMBERS:

We are currently seeking vol-unteers to join our HMP Advi-sory Group!

We are seeking members that are informed, engaged and collaborative in the con-tinued development and im-provement of the HMP. You can contact us at HMP@HSF.ca to volunteer!

Practice Reports are a key feature of the HMP, providing consistent metrics on care status & clinical indicators. But did you know that missing a diagnosis entry on the Baseline Flowsheet means that reports won’t accurately represent all of your enrolled patients?

Care status & clinical indicators are grouped by patients with Hypertension

and those with Elevated BP readings, relying on the diagnosis for accuracy.

How do you know if you have diagnosis gaps? The first page

of your practice report shows the % of missing diagnosis’

What needs to be done? Add a ’diagnosis’ to an HMP Flowsheet

(electronic sites) or add directly in the HMP Repository (paper sites).

Want a list of patients missing the diagnosis? The HMP website has a ‘Repository—Case Examples’ guide (‘HMP in

Practice’ section) that walks through creating a list of patients.

PRACTICE TIP: Using Practice Reports

Shared Medical Appointments (SMA) South Georgian Bay CHC shares their approach

Working on Quality Improvement Initiatives, the SGB CHC chose to implement SMAs for patients with diabe-tes, predicting that clients would benefit from coming together to learn and share existing knowledge and expe-riences living with diabetes, a setup that could easily be adapted to also address hypertension.

Approach: The team chose their RN-CDE and another RN to lead the SMA, supported by the NP diabetes lead and clinical admin support for planning and preparation. SMAs were set up as a 1.5hr session, serving 12-16 pa-tients, providing: a) education, b) support forum, c) individual clinical reviews and assessments.

The SMA: The session begins with introducing the health team, the goals of the SMA, followed by a specific ed-ucational topic prompting open discussion between patients and providers.

After the discussion, staff systematically visit each patient to record BP, review labs, medications and discuss current concerns with individuals. Patients can mingle and have snacks between clinical reviews.

At the end of the session, the group provides feedback for future sessions, and takes home lab requisition and appointment card for the next visit. Positive re-enforcement for the day’s topics/discussions close the session.

Outcomes: As SMAs took place the team noted group members were: more interactive with one another, if a member was struggling, there was definite support from the group; and more open to suggesting solutions to issues from their own experiences. Additionally, the team found they gained a better understanding of challenges patients were facing.

Why do we think it will work for hypertension? Clients have many questions around medication, lifestyle and self-monitoring that group discussions can sup-port. Lifestyle change is so important, to see another client modeling a behav-ior change can be inspiring, and may nudge others into action. Following up at the next visit offers motivation to meet their goals, encouraged by the group.

***SGB CHC shared their tools with HMP. Look for the SMA Agenda, Activity Schedule and Room Setup guides on our web page this September.***

Provided by: Susan Puttkemery, RN