Library Home Page

2025 CASE MANAGEMENT PRACTICE IMPROVEMENT AWARD

PROJECT TITLE: Improving Hypertension Control in the Black and African American Population

RECIPIENT: Trinity IHA Medical Group

CATEGORY: Patient Engagement

ABSTRACT: Trinity IHA Medical Group advanced health equity using a data informed approach and increasing connection to case management resources to improve the management of hypertension.   Black and African American individuals are 30 percent more likely to have hypertension.  Poorly managed hypertension leads to serious health consequences like heart attacks, strokes, kidney disease, and dementia.  Through stratification of hypertension management data, Trinity identified that its Black and African American patients were 7 percent less likely to have controlled hypertension than other cohorts. Trinity implemented a multi-pronged initiative across Family and Internal Medicine sites that focuses on better management of hypertension to  improve long-term health outcomes for Black and African American patients.  This program includes education, community-engagement, increased care coordination activities, structured treatment protocols, and access to case management resources to facilitate and support self-monitoring of blood pressure measurements.  These interventions empower clients to take a more active role in their care to improve their health and well-being.

RESULTS / OUTCOMES: Trinity implemented an approach that reduced the disparity in controlled hypertension for Black and African American patients from 7 percent to 4.5 percent in one year.  Controlled hypertension rates rose from 66.4% to 72.3%.   Additionally, there was increased engagement in pharmacy and case management services.  Trinity successfully engaged 5,799 patients who were previously absent to care.