System-level initiatives to reduce persistently elevated blood pressures in hypertensive patients: how do we overcome clinical inertia?

In the United States, research consistently shows around half of adults with hypertension do not achieve recommended control of their blood pressure (BP).1 Poor BP control at the population level then leads to higher rates of preventable negative cardiovascular outcomes, like strokes and heart attacks. As recently reported, Elizabeth Pfoh and colleagues studied a quality […]

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Unit culture, testing frequency, and simple interventions: more than meets the eye (test)

Recently, Benjamin Leis (@LeisBenjamin) and colleagues published a short report on an intervention in a cardiac intensive care unit (ICU) in Canada. In this study, the authors removed TSH testing from standard admission order sets with the aim of reducing the number of unnecessary thyroid studies obtained. Often, altering an order set like this is […]

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Top 2018 articles on quality improvement

Influencing organisational culture to improve hospital performance in care of patients with acute myocardial infarction: a mixed-methods intervention study – in print, March 2018 issue. https://qualitysafety.bmj.com/content/27/3/207 In this ambitious work, Curry et al. describe the effects on both culture and clinical outcomes of a 2-year organizational culture-improvement intervention at ten hospitals with at least 200 […]

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