Hypertension in Pregnancy Change Package

 What is the Hypertension in Pregnancy Change Package?
The Hypertension Control Change Package (HCCP) was originally published in 2015 and has been used in the field to improve hypertension (HTN) control by various health centers and clinics.1  New clinical guidelines, the development of new resources, and general advances in quality improvement for HTN management prompted the need for this updated version.

The HCCP lists process improvements that outpatient clinical settings can implement to achieve optimal HTN control.

The HCCP comprises change concepts, ideas, and evidence- or practice-based tools and resources.

  • Change concepts are general notions that are useful in developing more specific ideas for changes that lead to improvement.
  • Change ideas are actionable, specific suggestions for improving a process. They can be rapidly tested on a small scale to determine whether they improve the local environment.

With each change idea, the HCCP lists evidence-based tools and resources that can be adapted or adopted in a healthcare setting to improve HTN control.


What is Hypertensive Disorders in Pregnancy?
Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality. Because postpartum exacerbation of severe hypertension is common, the American College of Obstetricians and Gynecologists recommends that patients with severe hypertension during childbirth hospitalization be seen within 72 hours after discharge.

Organization   Resource
Society for Maternal-Fetal Medicine Society for Maternal-Fetal Medicine Special Statement: Quality metric for timely postpartum follow-up after severe hypertension
American College of Obstetricians and Gynecologists Gestational Hypertension and Preeclampsia
American College of Obstetricians and Gynecologists Chronic Hypertension in Pregnancy
California Maternal Quality Care Collaborative Improving Health Care Response to Hypertensive Disorders of Pregnancy Toolkit
California Maternal Quality Care Collaborative Low-Dose Aspirin (LDA) Campaign to Reduce Preeclampsia and Related Preterm Birth
Minnesota Perinatal Quality Collaborative Family of Measures, Stratify by race/ethnicity
Weill Cornell Medicine HTN QI: How to set up blood pressure flowsheet correctly
Duke University School of Medicine Management of Hypertension Guideline
Florida Perinatal Quality Collaborative Florida Hypertension in Pregnancy Toolkit
University Chicago Medicine STAMPP HTN: Systematic Treatment And Management of Postpartum Hypertension
Indiana Perinatal Quality Improvement Collaborative Preeclampsia Patient Education
Indiana Perinatal Quality Improvement Collaborative Ambulatory Preeclampsia Checklist
Indiana Perinatal Quality Improvement Collaborative Hypertension in Pregnancy-Ambulatory Readiness Assessment
ACOG District XII Cardiac Disease and Pregnancy
Illinois Perinatal Quality Collaborative Maternal Hypertension Grand Rounds
North and South Dakota Perinatal Quality Collaborative Hypertension Project 2021-2022: Learning Session 1
North and South Dakota Perinatal Quality Collaborative Hypertension Project 2022: Learning Session 2
Wisconsin Perinatal Quality Collaborative Aims/Goals Worksheet
Illinois Perinatal Quality Collaborative Illinois Maternal Hypertension Initiative Comprehensive Slide Set
Illinois Perinatal Quality Collaborative Mapping Tool Resources/Services in Hospital's Service Area to Address Patients' Social Determinants of Health
Illinois Perinatal Quality Collaborative Winnebago County resources
California Maternal Quality Care Collaborative CVD Risk Infographic
Wellspan Health Severe Hypertension Treatment and Follow-Up in Pregnancy and the Postpartum
Georgia Perinatal Quality Collaborative Cardiac Warning Watch Badge Buddy
Georgia Perinatal Quality Collaborative Cardiac Warning Watch Poster
CardioSmart Heart Health After Pregnancy
UConn Health Million Hearts® Self-Monitoring Blood Pressure (SMBP) Grant
Indiana Perinatal Quality Improvement Collaborative Blood Pressure Competency Checklist
Oklahoma Perinatal Quality Improvement Collaborative Preeclampsia Risk Assessment
Oklahoma Perinatal Quality Improvement Collaborative Provider Aspirin Decision Tree
Oklahoma Perinatal Quality Improvement Collaborative LDA Clinical Workflow
UNC Collaborative for Maternal and Infant Health Front Desk/Clinic Call Center Triage Flow Chart for Pregnant/Postpartum Patients with possible Severe Hypertensive Emergency
UNC Collaborative for Maternal and Infant Health OB Hypertensive Emergency Nifedipine Task Checklist
UNC Collaborative for Maternal and Infant Health Outpatient Hypertension Simulation Scenario
Jupiter Medical Center Medical Reconciliation Form
ACOG District II Oral Nifedipine Algorithm
Fort Health Care OB Hypertension
Northern Health Indigenous Health Cultural Safety, Respect and Dignity in Relationships
Baptist Health College Little Rock Plus Delta Debriefing Tool
American Medical Association Medication Management: Save Time by Simplifying Your Prescribing and Refill Process
American Medical Association Medication Adherence: Improve Patient Outcomes and Reduce Costs


Reference

1.  Million Hearts® | Centers for Disease Control and Prevention | Published September 8, 2023. Accessed April 10, 2024. https://millionhearts.hhs.gov/tools-protocols/action-guides/htn-change-package/index.html.