Plank	Description
Direct Care Staff Trained in Accurate BP Measurement	All team members involved in direct patient care should be trained in taking blood pressures according to a standard process. An annual evaluation/certification should involve both the ability to follow the process and blood pressure measurement accuracy. The entire on-site team should, through training, be aware of the importance of hypertension management and target blood pressures. Team members should be encouraged to comment to patients on their progress especially when not at goal.
Hypertension Guideline Used and Adherence Monitored	Each organization will adopt and deploy a process or algorithm to guide therapy in accordance with JNC 7 Guidelines. In addition, the ADA and NCQA goal for diabetic patients (140/90) should be included in the algorithm.
BP Addressed for Every Hypertension Patient at Every Primary Care or Cardiology Visit	This will occur without exception, and processes are in place to monitor adherence.
All Patients Not at Goal or with New Hypertension Rx Seen within 30 Days	When patients are not at goal or have had a new Rx or change in Rx, they should be scheduled for a return visit with primary care within 30 days. Visit reminders may be useful in ensuring that patients keep their appointments.
Prevention, Engagement and Self-Management Program in Place	There is a program to educate patients on lifestyle, diet, exercise, and the importance of taking antihypertension medications. The program emphasizes patient engagement in their care and teaches self-management skills.
Hypertension Registry Used to Track Patients	A method is in place to identify all hypertension patients before each visit and to note whether they have comorbid conditions that could affect their BP control, whether they are at goal, and whether there are gaps in care.
All Team Members Trained in Importance of BP Goals and Metrics	The entire on-site team should, through training, be aware of the importance of hypertension management and blood pressure goals. Team members should be encouraged to comment to patients on their progress and on the importance of medications, especially when patients are not at goal.
All Specialties Intervene with Patients Not in Control	All specialty departments should routinely take blood pressures of adult patients and refer the not-at-goal patients to primary care. When possible, a primary care appointment should be made before the patient leaves the specialty appointment.

©American Medical Group Foundation (AMGF), Measure Up/Pressure Down, Provider Toolkit. AMGF; 2013 (http://www.measureuppressuredown.com/HCProf/find/provtoolkit_find.asp).

ADA = American Diabetes Association; BP = blood pressure; JNC 7 = Seventh Report of the Joint National Committee on Prevention. Detection, Evaluation, and Treatment of High Blood Pressure; NCQA = National Committee for Quality Assurance; Rx = prescription.