Quality Improvement Strategies Recommendation for Quality Improvement Strategies References that support the recommendation are summarized in Online Data Supplements 66 and 67. COR LOE Recommendation IIa B-R 1. Use of quality improvement strategies at the health system, provider, and patient levels to improve identification and control of hypertension can be effective.S12.4.2-1 S12.4.2-8 Whelton et al 2017 High Blood Pressure Clinical Practice Guideline e75 Synopsis High-quality BP management is multifactorial and requires the engagement of patients, families, providers, and healthcare The difference between patient out- comes achieved with current hypertension treatment methods and patient outcomes thought to be possible with best-practice treatment methods is known as a quality gap, and such gaps are at least partly responsible for the loss of thousands of lives This includes expanding patient and healthcare provider awareness, appropriate lifestyle modifications, access to care, evidence-based treatment, a high level of medication adherence, and adequate follow-up.S12.4.2-9 Quality improvement strategies or interventions aimed at reducing the quality gap for a group of patients who are representative of those encoun- tered in routine practice have been effective in improving the hypertension care and outcomes across a wide variety of clinic and community settings.S12.4.2-1 S12.4.2-4,S12.4.2-6,S12.4.2-8,S12.4.2-10 Hypertension quality improvement strategies, with exam- ples of substrategies that have been demonstrated to reduce BP and improve BP, are provided in Online Data Supplement E. Because the effects of the different quality improvement strategies varied across trials, and most trials included >1 qual- ity improvement strategy, it is not possible to discern which specific quality improvement strategies have the greatest effects. Team-based care (see Section 12.4) and an organized system of regular review, with antihypertensive drug therapy implemented via a stepped-care protocol, had a clinically sig- nificant effect on reducing SBP and DBP and improving BP control. 