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  • 1.  Vital sign requirements

    Posted 12-19-2022 18:57
    Hello all, 

    I wanted to see if I could get some insight on vital signs in the outpatient setting. Are all vital signs (including pulse ox) required for all patients in primary care? Are there any vitals required for specialties (some or all)? Any insight would be great. Our current SOP does not directly state what is required and my team and I are trying to standardize for primary care, specialties, urgent care, etc. Thanks for any responses. 



     

    Quiana Simmons, MSN, RN AMB-BC
    Metrohealth Medical Center
    Nursing Professional Development Specialist- Ambulatory
    Cell: 216-509-5654



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    Quiana Simmons
    Metrohealth Medical Center
    Garfield Heights OH
    (216)509-5654
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  • 2.  RE: Vital sign requirements

    Posted 12-20-2022 08:23
    Good Morning Guiana,

    As hypertension control is a HEIDIS measure our health system does VS in both primary care and specialty practices.  We are working through a process for specialty to notify primary care when the BP is elevated at specialty, unless specialty is managing the BP. 

    Samantha Obeck, DNP, RN
    Director Clinical Development
    sobeck@wellspan.org
    717-851-7245
    WellSpan Admin Bld
    601 Memory Lane
    York, PA 17402



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    Samantha Obeck
    Quality Improvement Coordinator
    WellSpan Health
    Leola PA
    717-648-5232
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  • 3.  RE: Vital sign requirements

    Posted 12-20-2022 08:31
    Hello Samantha, 

    We have a safeguard built in Epic (BPA) that alerts our staff to schedule a HTN nurse visit in the primary care office the patient is assigned to. Regardless of where it was taken, it is a requirement for medical assistants. What I found is that when patients are in specialty clinics, the providers are not requiring all vitals to be taken so that throws us back with HTN follow up. 

    Quiana

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    Quiana Simmons
    Metrohealth Medical Center
    Garfield Heights OH
    (216)509-5654
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  • 4.  RE: Vital sign requirements

    Posted 12-21-2022 10:11
    Quiana -   The VA follows the Controlling High Blood Pressure (CBP) HEDIS measure which requires a blood pressure be taken each year for all patients with a hypertension diagnosis.  In primary care, this means that if a patient has not been seen in primary care in over one year, they are not meeting this measure.  This is a difficult measure to keep up with, especially with the COVID pandemic and patients avoiding clinic visits.  Due to this difficulty, I think all VS should be taken each time the patient is seen whether it's in primary care or a specialty clinic.  If during the visit, the patient is not meeting the 140/90 or below requirement, a second BP at the end of the visit should be taken. If the second BP is still not within range, a follow up clinic visit or video visit with the RN is needed.  Adopting this as a standardized practice would sure help all clinics meet this HEDIS measure.   Attaching the HEDIS requirement here:

    Every patient aged 18-85 with a diagnosis of hypertension during the measurement year should have a controlled blood pressure reading documented. Controlling high blood pressure is an important step in preventing heart attacks, stroke and kidney disease, and in reducing the risk of developing other serious conditions. Control is being defined by NCQA HEDIS as: Systolic <140 and Diastolic <90.



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    Sally Packard
    VA Boise Idaho
    Mesa AZ
    (805)440-9906
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