Use of Care Coordination and Community Resources for Hypertension Management

According to Patrício et al. (2020), care coordination and utilizing community resources can be powerful tools to address patient, family, or population problems in healthcare (Patrício et al., 2020). Berwick (2019) indicates that one evidence-based care coordination model is the Chronic Care Model (CCM), which focuses on improving healthcare conditions for patients with chronic diseases such as hypertension. In this model, healthcare providers collaborate to deliver comprehensive, coordinated treatment and care tailored to each patient’s requirements. The CCM also emphasizes the importance of self-management support, as patients with chronic conditions often need to be actively involved in managing their health. The model has been shown as patient-friendly and cost-effective, ensuring safe patient outcomes (Berwick, 2019). According to Proboningsih (2023), implementing the CCM in hypertension management can improve blood pressure control, decrease hospitalizations, and reduce healthcare costs (Proboningsih et al., 2023).

Telehealth can be another helpful strategy in hypertension management in fostering care coordination. According to Santos et al. (2022), patients can use mobile apps and wearable devices to track their blood pressure and report the data to their nurses. Nurses utilize this information to make more informed treatment decisions. Telehealth can also facilitate remote consultations, allowing nurses and physicians to communicate with patients regardless of location (Santos et al., 2022).

Role of Community Resources in Care Coordination

Community resources play an essential role in care coordination by providing access to various services and support outside traditional healthcare settings (Patrício et al., 2020). Resources such as pharmacies, home health services, and community health clinics can play a central role in hypertension management (Hoehns et al., 2020). According to Vedanthan et al. (2019), community health clinics often offer blood pressure screenings and education on hypertension management, which can help individuals understand their condition and take steps to manage it. Additionally, community health clinics may offer nutrition counseling and exercise programs to help individuals make lifestyle changes to lower their blood pressure (Vedanthan et al., 2019). The Center for Disease Control and Prevention (CDC) is a valuable community resource for hypertension management (Stupplebeen et al., 2019). According to Ritchey (2020), CDC’s Million Hearts initiative is centered on preventing one million strokes and heart attacks until 2022, applying strategies such as hypertension management. The CDC offers blood pressure measurement protocols, clinical practice guidelines, and patient education materials on hypertension (Ritchey, 2020).

Potential Barriers

According to Morrison et al. (2021), patients may need more financial resources to access necessary care or medications. This can lead to poor adherence to treatment and uncontrolled hypertension. Additionally, nurses may have a high workload and limited time with patients making it difficult to coordinate care effectively. It also leads to missed opportunities for education, follow-up, and monitoring.

Expected Outcomes and Effectiveness

In the case of David, the use of community resources and collaborative care play a crucial role in addressing his hypertension management and preventing further complications. Based on the evaluation of the practicum session with David, I suggested joining support groups and educational programs that can provide him with information about lifestyle management and skills to manage his hypertension effectively. These programs can also offer referrals to specialists in case of complicated hypertension management issues (Tavakoly Sany et al., 2020).