Improving the quality of hypertension care at Cloetesville Community Day Centre (CDC) : a quality improvement cycle
Thesis (MFamMed)--Stellenbosch University, 2015.
ENGLISH SUMMARY: Background: Hypertension is one of the most common chronic diseases worldwide and is estimated to contribute 9% of all deaths in South Africa, where it is also the commonest condition seen in ambulatory primary care. Despite advances in treatment of this disease and clear guidelines, quality of care is still lacking. Aim: To improve the quality of hypertension care by means of a Quality Improvement Cycle. Setting: Cloetesville Community Day Centre, Stellenbosch, Western Cape Methods: Two hundred folders were randomly selected and audited. Following this, interventions to improve clinical practice included training of nursing staff on taking blood pressure measurements accurately, teaching sessions on the latest evidence based hypertension guidelines and promoting standardised quality of care. A re audit was done one year later and the results compared. Results: Fifty nine per cent were women with a mean age of 58 years. In both audits all of the structural target standards were met. During the re-audit only 3/12 process target standards were met, but there was a significant improvement (p<0.05) in 9/12 criteria. Blood pressure control was achieved in 61% of patients showing a slight improvement from the baseline audit of 57%. Conclusion: The quality improvement cycle demonstrated significant improvements in the process and outcome of care following relatively simple interventions and changes to clinical practice. It is recommended that the quality improvement process should continue with new interventions, be expanded to other health centres in this sub district and beyond and to other chronic diseases.
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