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 a variety of health centers and clinics.¹  New clinical guidelines, development of new resources, and general advances in quality improvement for HTN management prompted the need for this updated version.

The HCCP presents a listing of process improvements that outpatient clinical settings can implement as they seek optimal HTN control.

The HCCP is composed of change concepts, change ideas, and evidence- or practice based-tools and resources.

• Change concepts are general notions that are useful in the development of more specific ideas for changes that lead to improvement.
• Change ideas are actionable, specific ideas for changing a process. Change ideas can be rapidly tested on a small scale to determine whether they result in improvements in the local environment.

With each change idea the HCCP lists evidence- or practice-based tools and resources that can be adapted or adopted in a health care 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 the 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.