ArticleAnnals of family medicine2018
Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.
Article in Annals of family medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Federal Investment in Primary Care Transformation: A Systematic Review and Qualitative Analysis.JAMA health forum · 2025Pooled it
- Trial
- Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study.BMC health services research · 2020Article
- The Capacity of Primary Care for Improving Evidence-Based Care: Early Findings From AHRQ's EvidenceNOW.Annals of family medicine · 2018Article
- Finding a Parsimonious Path for Primary Care Practice Transformation.Annals of family medicine · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeOur purpose was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control.
methodsWe divided practices into quartiles of blood pressure control performance and considered the top quartile as the benchmark for comparison. Using abstracted clinical data from electronic health records, we performed a cross-sectional study to assess the association of top quartile hypertension control and (1) the baseline practice adaptive reserve (PAR) scores and (2) baseline practice leadership scores, using modified Poisson regression models adjusting for practice-level characteristics.
resultsAmong 181 practices, 46 were in the top quartile, which averaged 68% or better blood pressure control. Practices with higher PAR scores compared with lower PAR scores were not more likely to reside in the top quartile of performance (prevalence ratio [PR] = 1.92 for highest quartile; 95% CI, 0.9-4.1). Similarly, high quality improvement leadership capability compared with lower capability did not predict better blood pressure control performance (PR = 0.94; 95% CI, 0.57-1.56). Practices with higher proportions of commercially insured patients were more likely than practices with lower proportions of commercially insured patients to have top quartile performance (37% vs 26%,
conclusionsOur findings show that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project. Our findings, however, may be limited by a lack of patient-related factors and small sample size to preclude strong conclusions.
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