Assessment of an Ambulatory Blood Pressure Monitoring Protocol in an Academic Outpatient Clinic

Abstract

Purpose: To evaluate the initial implementation effectiveness of an ambulatory blood pressure monitoring (ABPM) protocol based on provider perception through survey and assesses its fidelity, adoption, and impact in an academic outpatient clinic. Methods: A prospective study was conducted. A protocol was created to implement an ABPM device for use in patients who qualified in the clinic. Providers and staff were educated on the workflow steps and the importance of utilizing ABPM to detect and manage hypertension (HTN). Surveys were distributed before implementation of the protocol and two months after the initial implementation date. The primary outcome was a change in the composite provider survey score. Results: Thirty-two pre-surveys and 13 post-surveys were collected. The majority of pre-survey and post-survey responses were completed by post-graduate year three resident physicians (28% vs. 36% respectively). Eightyfive percent and 92% of providers had zero to five years of experience for pre-survey and post-survey responses, respectively. Following the ABPM protocol implementation, the composite provider score increased from a pre-survey score of 25 to a post-survey score of 32 (p = 0.0024). Conclusion: Education is a critical component in creating a new service, and the support of all clinic providers and the staff was vital in a successful implementation. With proper dissemination and education, provider perception of ABPM was positive, and the tool’s interest grew.