Jennifer Lea & Malerie Murphy
July 25, 2010
PHC 6000
Case Study: Effects of Primary, Secondary, and Tertiary Prevention on the Development of a Hypertension program at ORMC * We did not plagiarize on any aspect of this paper
Executive Summary
Description:
Orlando Health, one of Florida’s largest non-profit health care networks, provides quality health care to nearly 2 million Central Florida residents and 4500 international visitors (ORMC, 2010). Orlando Health is comprised of eight health care facilities in total, Orlando Regional Medical Center (ORMC) being the flagship medical center. Orlando Regional Medical Center is the only Level 1 Trauma Center in Central Florida and one of six in the entire state of Florida. ORMC prides itself in its comprehensive cutting edge technology and medical expertise, specializing in trauma care, cardiovascular care, stroke, and several other key medical areas. The mission of ORMC is to improve the health and quality of life of all individuals in the Central Florida community and surrounding areas. Orlando Regional Medical Center’s goal in improving quality of care leads to specific focus on one of the leading causes of death, hypertension or high blood pressure.
Orlando Regional Medical Center (ORMC) is taking initiative in implementing a Hypertension Awareness Program. Hypertension is a life-threatening disease that affects one in every three Americans in the United States today (DHDSP, 2010). The mission of the ORMC program is to promote a heart-healthy lifestyle for Central Florida residents to prevent and control hypertension. As approximately 90% of Americans will develop high blood pressure in their lifetime, Orlando Regional Medical Center strives to prevent this from occurring to the Central Florida residents and visitors it provides care to currently and in the future. According to ORMC, on average, one American dies every two minutes from complications of high blood pressure. (ORMC, 2010)
Orlando Regional Medical Center recognizes the need to put a hypertension awareness program in place. Identifying and evaluating high blood pressure risk factors is imperative in understanding the needs associated with prevention, control, and maintenance of those in risk of developing or those already living with hypertension. High blood pressure is a preventable disease that ultimately reflects one’s behavior and environmental choices. Orlando Regional Medical Center believes developing this program will help achieve its goal in lowering health care cost, reducing patient emergency room visits, and increasing quality of care.
Orlando Regional Medical Center wants to answer a number of critical and fundamental questions to help best plan their new program:
Questions:
1. Using the information below, identify the need for having a hypertension program at ORMC.Explain how all of these variables play an important role in developing an effective program.
2. How do the primary, secondary and tertiary preventative strategies impact the development of this program?Be specific with what each requires and their independent impact on the development of a hypertension program.
3. There are many key elements that are a part of any program design.Identify all of the different elements that are critical for helping this program succeed. Answers and Teaching Notes
1. There is a critical need for a hypertension awareness program at ORMC and in the central Florida area.ORMC is a well recognized heart-healthy facility that prides itself of on promoting a heart-healthy lifestyle.As ORMC develops a hypertension program it is important to first consider the need for such a program.The need can be identified by the prevalence of hypertension in the central Florida area, heart-related mortality rates, prevalence rates of the risk factors associated with hypertension, and the cost of hypertension in the U.S., Florida, and Central Florida areas.These key indicators can identify the need for establishing a hypertension program.
2. In Orange County alone, the prevalence of hypertension is 25.6% (FDOH, 2010).).This two numbers are important when developing a hypertension program because they address the need.Also important is to look at heart-related mortality rates.If one examines the state of Florida 1 in every 4 deaths is directly related to heart disease.In Orange County there were 170,900 heart-related deaths and 61% of those who died had hypertension.This shows a significant need for creating an effective program that raises awareness for hypertension and its associated risk factors.
Risk factors for hypertension include smoking, overweight, decreased physical activity, poor dietary habits, stress, diabetes, and family history.One needs to evaluate the prevalence of some of the risk factors to determine the focus areas of the hypertension program.The prevalence for diabetes in Orange County is 45.6%, sedentary lifestyle is 23.1%, smoking is 14.6%, overweight and obese is 62.0%, and poor dietary habits is about 69.5% (FDOH, 2007).One should consider focus areas to be weight management, improved dietary habits, smoking cessation, and increased physical activity.
The estimated cost of incremental medical costs directly associated with hypertension in the U.S. in 2001 was $55 billion (Balu, 2001).In 2010 that number has increase to $76.6 billion (CDC, 2010).The cost of hypertension in Florida is estimated to be $191 to $335 million (Brookes, 2007).These numbers show the inherent need for an effective hypertension awareness program.
3. Nutrition strategies, blood pressure screening, medication adherence, education, awareness, smoking cession, diabetes management, stress management, weight loss, and physical activity are all key elements of the program design.Most of these key elements are behavioral modifications that a patient can make to decrease their risk of developing hypertension.Due to the relationship of each of the key elements and one’s risk of developing hypertension it is extremely important for the patients to identify areas for improvement to decrease relative risk of hypertension.By including these different elements in the ORMC hypertension program one can ensure that each risk factor is addressed and modified appropriately.Also, these elements are important because the program design needs to focus on the hypertension education and awareness.Education and awareness of hypertension is deeply rooted in these behavioral modifications.For example, if a patient decreases their weight by 10 pounds they can significantly lower their blood pressure (DHHS, 2003).All of these elements will make the ORMC hypertension program effective.
U.S. Department of Health and Human Services (DHHS): Center for Disease Control and Prevention, National Center for Health Statistics. (2009)Health, United States, 2009.Retrieved from http://www.cdc.gov/nchs/data/hus/hus09.pdf on June 23, 2010.
Division for Heart Disease and Stroke Prevention (DHDSP). (2010). High Blood Pressure Fact Sheet. Retrieved on July 8, 2010 at http://www.cdc.gov/dhdsp/library/fs_bloodpressure.htm
Division for Heart Disease and Stroke Prevention (DHDSP). (2010). State Program: Florida basic Implementation. Retrieved on July 8, 2010 at http://www.cdc.gov/dhdsp/state_program/fl.htm
Fleming, S. (2008) Managerial Epidemiology: Concepts and Cases. Chicago, IL: Health administration Press 2nd edition, Chapter 2: Infectious Disease Epidemiology
Florida Department of Health (FDOH) (2007) Orange County Disease Profile.Retrieved from http://www.floridacharts.com/charts/brfss.aspx on July 24, 2010.
Florida Department of Health (FDOH) (2010) Orange County Disease Profile. Retrieved from http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244&County=48&year=2008 on July 7, 2010. Orlando Regional Medical Center (ORMC). (2010). Orlando Health. Retrieved on July 20, 2010 http://www.orlandohealth.com/orlandoregionalmedicalcenter/AboutUs/AboutUs.aspx?pid=2685 Appendix The synergy of our team was exceptional. We again worked very well together throughout the entire development of our case study, from beginning to end. We used both the knowledge we had gained from previous research throughout the course, the course textbook, our own personal backgrounds in health care, and information from a Central Florida hospital, Orlando Regional Medical Center. We began this paper by first brainstorming a Case Study topic that we found would be an interesting focus point with regards to hypertension. The topic we chose was the primary, secondary, and tertiary preventative strategies for hypertension. We both believe high blood pressure is a very preventable disease and with simple lifestyle changes, huge benefits will occur. High blood pressure cannot only be prevented by living a heart-healthy lifestyle, it can also be maintained or lowered through the behavioral decisions every American makes throughout their lifetime. Our Case Study focused on the implementation of a hypertension awareness program in one specific Central Florida hospital, Orlando Regional Medical Center (ORMC). We thought this would be a creative way to relate all we have learned throughout the entire semester on our epidemiology topic, hypertension. We tied in the research we had found on hypertension including prevalence around the world, the United States, and Florida, risk factors, and preventative strategies to relate all to ways in which the medical care provider can use the information in assessing the needs to develop the specific program. We believe that one hospital can impact the entire community and furthermore, the entire state of Florida. Central Florida residents need to be educated and made aware of their risks for developing high blood pressure. We chose Orlando Regional Medical Center because it is associated with the Orlando Health network that is composed of eight other health care facilities. Orlando Regional Medical Center is not only a Level 1 trauma center, it also one of Florida’s top medical teaching facilities which is the future of health care. In developing our case study, we decided to outline our paper together as we thought this would allow us to properly organize the paper. Malerie focused on developing the description and background of the paper. Jenn developed the teaching notes and answers to the questions we had proposed for the Case Study. We worked together on formulating the key questions we wanted to answer that would help the proposed need for a hypertension awareness program at Orlando Regional Medical Center. We communicated through facebook, telephone, and the course email throughout the entire project. We both learned a tremendous amount of information about hypertension and all that it encompasses. We realize the importance of high blood pressure education and awareness is on saving millions of Americans lives. Hypertension is not only an epidemic in the United States, it’s globally one of the leading causes of deaths. We are glad we can share the information we have learned with the entire class and hope that small changes in the Central Florida area can influence the rest of the nation. We will do our part in educating our friends, family, and coworkers on the importance of getting your blood pressure checked and engaging in a heart-healthy lifestyle. We hope the rise in those living with high blood pressure ends, and a decrease occurs within the next couple of years.
Jennifer Lea & Malerie Murphy
July 25, 2010
PHC 6000
Case Study:
Effects of Primary, Secondary, and Tertiary Prevention on the Development of a Hypertension program at ORMC
* We did not plagiarize on any aspect of this paper
Executive Summary
Description:
Orlando Health, one of Florida’s largest non-profit health care networks, provides quality health care to nearly 2 million Central Florida residents and 4500 international visitors (ORMC, 2010). Orlando Health is comprised of eight health care facilities in total, Orlando Regional Medical Center (ORMC) being the flagship medical center. Orlando Regional Medical Center is the only Level 1 Trauma Center in Central Florida and one of six in the entire state of Florida. ORMC prides itself in its comprehensive cutting edge technology and medical expertise, specializing in trauma care, cardiovascular care, stroke, and several other key medical areas. The mission of ORMC is to improve the health and quality of life of all individuals in the Central Florida community and surrounding areas. Orlando Regional Medical Center’s goal in improving quality of care leads to specific focus on one of the leading causes of death, hypertension or high blood pressure.
Orlando Regional Medical Center (ORMC) is taking initiative in implementing a Hypertension Awareness Program. Hypertension is a life-threatening disease that affects one in every three Americans in the United States today (DHDSP, 2010). The mission of the ORMC program is to promote a heart-healthy lifestyle for Central Florida residents to prevent and control hypertension. As approximately 90% of Americans will develop high blood pressure in their lifetime, Orlando Regional Medical Center strives to prevent this from occurring to the Central Florida residents and visitors it provides care to currently and in the future. According to ORMC, on average, one American dies every two minutes from complications of high blood pressure. (ORMC, 2010)
Orlando Regional Medical Center recognizes the need to put a hypertension awareness program in place. Identifying and evaluating high blood pressure risk factors is imperative in understanding the needs associated with prevention, control, and maintenance of those in risk of developing or those already living with hypertension. High blood pressure is a preventable disease that ultimately reflects one’s behavior and environmental choices. Orlando Regional Medical Center believes developing this program will help achieve its goal in lowering health care cost, reducing patient emergency room visits, and increasing quality of care.
Orlando Regional Medical Center wants to answer a number of critical and fundamental questions to help best plan their new program:
Questions:
1. Using the information below, identify the need for having a hypertension program at ORMC.Explain how all of these variables play an important role in developing an effective program.
2. How do the primary, secondary and tertiary preventative strategies impact the development of this program?Be specific with what each requires and their independent impact on the development of a hypertension program.
3. There are many key elements that are a part of any program design.Identify all of the different elements that are critical for helping this program succeed.
Answers and Teaching Notes
1. There is a critical need for a hypertension awareness program at ORMC and in the central Florida area.ORMC is a well recognized heart-healthy facility that prides itself of on promoting a heart-healthy lifestyle.As ORMC develops a hypertension program it is important to first consider the need for such a program.The need can be identified by the prevalence of hypertension in the central Florida area, heart-related mortality rates, prevalence rates of the risk factors associated with hypertension, and the cost of hypertension in the U.S., Florida, and Central Florida areas.These key indicators can identify the need for establishing a hypertension program.
2. In Orange County alone, the prevalence of hypertension is 25.6% (FDOH, 2010).).This two numbers are important when developing a hypertension program because they address the need.Also important is to look at heart-related mortality rates.If one examines the state of Florida 1 in every 4 deaths is directly related to heart disease.In Orange County there were 170,900 heart-related deaths and 61% of those who died had hypertension.This shows a significant need for creating an effective program that raises awareness for hypertension and its associated risk factors.
Risk factors for hypertension include smoking, overweight, decreased physical activity, poor dietary habits, stress, diabetes, and family history.One needs to evaluate the prevalence of some of the risk factors to determine the focus areas of the hypertension program.The prevalence for diabetes in Orange County is 45.6%, sedentary lifestyle is 23.1%, smoking is 14.6%, overweight and obese is 62.0%, and poor dietary habits is about 69.5% (FDOH, 2007).One should consider focus areas to be weight management, improved dietary habits, smoking cessation, and increased physical activity.
The estimated cost of incremental medical costs directly associated with hypertension in the U.S. in 2001 was $55 billion (Balu, 2001).In 2010 that number has increase to $76.6 billion (CDC, 2010).The cost of hypertension in Florida is estimated to be $191 to $335 million (Brookes, 2007).These numbers show the inherent need for an effective hypertension awareness program.
3. Nutrition strategies, blood pressure screening, medication adherence, education, awareness, smoking cession, diabetes management, stress management, weight loss, and physical activity are all key elements of the program design.Most of these key elements are behavioral modifications that a patient can make to decrease their risk of developing hypertension.Due to the relationship of each of the key elements and one’s risk of developing hypertension it is extremely important for the patients to identify areas for improvement to decrease relative risk of hypertension.By including these different elements in the ORMC hypertension program one can ensure that each risk factor is addressed and modified appropriately.Also, these elements are important because the program design needs to focus on the hypertension education and awareness.Education and awareness of hypertension is deeply rooted in these behavioral modifications.For example, if a patient decreases their weight by 10 pounds they can significantly lower their blood pressure (DHHS, 2003).All of these elements will make the ORMC hypertension program effective.
U.S. Department of Health and Human Services (DHHS): Center for Disease Control and Prevention, National Center for Health Statistics. (2009)Health, United States, 2009.Retrieved from http://www.cdc.gov/nchs/data/hus/hus09.pdf on June 23, 2010.
Division for Heart Disease and Stroke Prevention (DHDSP). (2010). High Blood Pressure Fact Sheet. Retrieved on July 8, 2010 at http://www.cdc.gov/dhdsp/library/fs_bloodpressure.htm
Division for Heart Disease and Stroke Prevention (DHDSP). (2010). State Program: Florida basic Implementation. Retrieved on July 8, 2010 at http://www.cdc.gov/dhdsp/state_program/fl.htm
Fleming, S. (2008) Managerial Epidemiology: Concepts and Cases. Chicago, IL: Health administration Press 2nd edition, Chapter 2: Infectious Disease Epidemiology
Florida Department of Health (FDOH) (2007) Orange County Disease Profile.Retrieved from http://www.floridacharts.com/charts/brfss.aspx on July 24, 2010.
Florida Department of Health (FDOH) (2010) Orange County Disease Profile. Retrieved from http://www.floridacharts.com/charts/DisplayHTML.aspx?ReportType=7244&County=48&year=2008 on July 7, 2010.
Orlando Regional Medical Center (ORMC). (2010). Orlando Health. Retrieved on July 20, 2010 http://www.orlandohealth.com/orlandoregionalmedicalcenter/AboutUs/AboutUs.aspx?pid=2685
Appendix
The synergy of our team was exceptional. We again worked very well together throughout the entire development of our case study, from beginning to end. We used both the knowledge we had gained from previous research throughout the course, the course textbook, our own personal backgrounds in health care, and information from a Central Florida hospital, Orlando Regional Medical Center. We began this paper by first brainstorming a Case Study topic that we found would be an interesting focus point with regards to hypertension. The topic we chose was the primary, secondary, and tertiary preventative strategies for hypertension. We both believe high blood pressure is a very preventable disease and with simple lifestyle changes, huge benefits will occur. High blood pressure cannot only be prevented by living a heart-healthy lifestyle, it can also be maintained or lowered through the behavioral decisions every American makes throughout their lifetime.
Our Case Study focused on the implementation of a hypertension awareness program in one specific Central Florida hospital, Orlando Regional Medical Center (ORMC). We thought this would be a creative way to relate all we have learned throughout the entire semester on our epidemiology topic, hypertension. We tied in the research we had found on hypertension including prevalence around the world, the United States, and Florida, risk factors, and preventative strategies to relate all to ways in which the medical care provider can use the information in assessing the needs to develop the specific program. We believe that one hospital can impact the entire community and furthermore, the entire state of Florida. Central Florida residents need to be educated and made aware of their risks for developing high blood pressure. We chose Orlando Regional Medical Center because it is associated with the Orlando Health network that is composed of eight other health care facilities. Orlando Regional Medical Center is not only a Level 1 trauma center, it also one of Florida’s top medical teaching facilities which is the future of health care.
In developing our case study, we decided to outline our paper together as we thought this would allow us to properly organize the paper. Malerie focused on developing the description and background of the paper. Jenn developed the teaching notes and answers to the questions we had proposed for the Case Study. We worked together on formulating the key questions we wanted to answer that would help the proposed need for a hypertension awareness program at Orlando Regional Medical Center. We communicated through facebook, telephone, and the course email throughout the entire project.
We both learned a tremendous amount of information about hypertension and all that it encompasses. We realize the importance of high blood pressure education and awareness is on saving millions of Americans lives. Hypertension is not only an epidemic in the United States, it’s globally one of the leading causes of deaths. We are glad we can share the information we have learned with the entire class and hope that small changes in the Central Florida area can influence the rest of the nation. We will do our part in educating our friends, family, and coworkers on the importance of getting your blood pressure checked and engaging in a heart-healthy lifestyle. We hope the rise in those living with high blood pressure ends, and a decrease occurs within the next couple of years.