Team-based care
High-quality routine blood pressure care from healthcare workers, not just physicians
Challenge
More than a billion people live with high blood pressure, but there aren’t enough physicians for the life-long routine care needed to help keep everyone’s high blood pressure controlled.
Solution
Under team-based care, healthcare workers such as nurses, community health workers, and pharmacists train to work together to provide quality blood pressure care in non-specialty clinics.
Impact
Healthcare workers trained to provide quality routine care work together to treat more patients each day and allow doctors to focus on complex cases, improving primary healthcare for everyone.
What is team-based care?
With team-based care, non-physician healthcare workers such as nurses, community health workers, and pharmacists take on routine but time-consuming tasks like measuring blood pressure, refilling prescriptions, counseling, and initiating treatment.
Activities suited to each cadre in a team-based care model
| Cadre | |||||
|---|---|---|---|---|---|
| Activity |
 Doctor |
 Nurse |
 Community health worker |
 Pharmacist |
 Clerk |
| BP screening & measurement | |||||
| History & assessment | |||||
| Diagnosis & treatment initiation | • | • | • | ||
| Education & counselling | |||||
| Treatment adjustment | • | • | • | ||
| Medication refill | • | ||||
| Complex cases | |||||
| Patient follow-up | |||||
| Referral to other facilities | • | ||||
| Updating patient records after task performed | |||||
| Patient data management | |||||
Well-suited for cadre
Cadre can perform, but suitable to delegate
•Can perform under proper training and supervision, and with legal authority
How team-based care works
Imagine that you’re a physician in a busy clinic that serves hundreds of patients a day. You’d have only three or four minutes with each patient—time to take blood pressure, but not much else.
With team-based care, non-physician healthcare workers are trained to perform routine tasks that are part of blood pressure care, a small shift in responsibilities can make a big difference:
- More healthcare workers are available to see patients.
- Patients can receive regular follow-ups at a facility closer to home—like a local primary healthcare clinic—where specialized providers may not always be present.
- Doctors are freed up to provide supervision and to focus on complex cases.
- Clinics run more smoothly, improving outcomes for everyone seeking care, not just people living with high blood pressure.
Highlights
Guide: Team-based hypertension management in primary healthcare
Guidance and resources to assist in implementing team-based care for hypertension at the primary healthcare facility level
Expanding team-based care for hypertension
Special report from our partners at HEARTS in the Americas
The role of nurses in hypertension management in India
A time-motion study to understand how nurses manage blood pressure in primary health facilities and opportunities for improvement with digital tools
How we support team-based care
We work with partners to make team-based care a part of their blood pressure management programs. We support:
- Simple, standardized treatment protocols, which make it possible for healthcare workers to safely treat uncomplicated high blood pressure.
- Training in blood pressure management for healthcare workers, including on-demand training on smartphones, supportive supervision and mentoring.
- Validated digital blood pressure devices, which make it easy to take blood pressure accurately, every time. See box below.
- Digital health records that travel with the patient to any facility or doctor they choose.
- Telemedicine services so healthcare workers can receive real-time support from specialists when needed.
Technology that powers team-based care: Validated digital blood pressure devices
We need good data to make life-or-death decisions about blood pressure management. Inaccurate blood pressure readings can leave patients vulnerable to heart attack and stroke.
Validated automated blood pressure devices reduce human error and make it possible for nurses and community health workers to take accurate blood pressure readings consistently.
But regulation is weak, and most automated blood pressure devices in global markets aren’t independently validated. This and other challenges—low trust, limited awareness, poor availability, and affordability constraints— mean digital blood pressure devices are not used widely enough.
RTSL partners with hypertension control programs to promote exclusive use of these monitors, ensuring accurate blood pressure measurement every time.
