Use this decision analysis worksheet to analyze your chosen issue and the decision being made to resolve it. For each question in the worksheet, briefly share your experiences or observations related to your chosen issue or the decision being made. Please limit your response for each question to no more than one paragraph.
To use this worksheet, replace bracketed text with relevant information.
| Decision Analysis Questions | Experience/Observation |
| Describe the issue or problem that required a decision. | Controlling members blood pressure (BP), is a gap in care that is difficult to meet quality outcomes on. Every year the number of member that have an elevated blood pressure that is not within a normal range is rising. The targeted population size for controlling blood pressure seems to lean more towards the aging population, decision making can be key to successful aging. |
| What bias could be put on the question? In other words, what aspects of the situation can be ignored or assumed? | Some clinicians taking a BP can round a digit up or down by their choosing. “There is evidence that measuring BP manually, using an aneroid or mercury column sphygmomanometer, is associated with systematic recording errors including end digit preference (EDP) and observer bias” (Greiver et al., 2019, para. 9). There is also a link to the African American population having an increased rate of hypertension. African American women have compounding affects of both race and gender discrimination and have to overcome this dual bias. “Black women with high blood pressure who experienced high levels of stress were substantially less likely to take medication or practice blood pressure-lowering behaviors such as exercising or eating a healthy diet” (Williamson, 2021, para. 14). |
| What criteria can be used to measure success? | Proper documentation around starting blood pressure and BP when a program has concluded will yield if there are successful outcomes. |
| What experiences can be used in thinking about this issue? | Hypertension has been studied for many years. Taking an adequate BP is vital to proper outcomes. Understanding that elevated blood pressure occurs more frequently in the African American population needs to be addressed for health equality. Health care providers needs to assess a BP at the beginning and end of the visit to avoid white coat syndrome. “This |
| Decision Analysis Questions | Experience/Observation |
| phenomenon is defined as white coat syndrome – a change in BP levels due to the presence of a physician or other health professional” (Pioli et al., 2018, para. 1). | |
| What metaphors, if any, can be used in thinking about this issue? For example: “Don’t throw the baby out with the bathwater.” | They are just a heart attack waiting to happen. Otherwise, there are no real metaphors associated with hypertension. |
| Why might you or your group think about this issue or problem the way you do? | Controlling blood pressure has lasting effects on the body, including the brain, heart, and lungs. Having elevated BP or hypertension contributes to the body’s organs working harder than they should have to. These can lead to stroke, heart attack or a blood clot to the lungs. There are valuable resources available for all people that take advantage of them. |
| What does your frame/perspective of the issue emphasize? | The frame or perspective is around controlling BP in both White and African American people. There needs to be equality and understanding disparities around hypertension and controlling BP levels. |
| What does your frame minimize? | It minimizes the need for other more critical or invasive health care treatments or procedures. By getting blood pressure under control, you eliminate that necessity. |
| How might others in a similar setting or industry think differently about this question from the way you do? | This is an issue that most of the health care industry look at in the same manner. |
| What slogan might best summarize your frame/perspective? For example: First come, first served. | Get your Blood Pressure Numbers under Control! |
| What decision-making format did you use? (Committee? Survey? Something else?) | Charting audits |
References:
Greiver, M., Kalia, S., Voruganti, T., Aliarzadeh, B., Moineddin, R., Hinton, W., Dawes, M., Sullivan, F., Syed, S., Williams, J., & de Lusignan, S. (2019). Trends in end digit preference for blood pressure and associations with cardiovascular outcomes in Canadian and UK primary care: a retrospective observational study. BMJ OPEN, 9(1), e024970. https://doi-org.ezproxy.snhu.edu/10.1136/bmjopen-2018-024970
Pioli, M. R., Ritter, A. M. V., Faria, A. P. de, & Modolo, R. (2020). White coat syndrome and its variations: differences and clinical impact. Integrated Blood Pressure Control, 73b. https://doi-org.ezproxy.snhu.edu/10.2147/IBPC.S152761
Williamson, L. (2021, April 15). The link between structural racism, high blood pressure and Black People’s Health. www.heart.org. Retrieved June 19, 2022, from https://www.heart.org/en/news/2021/04/15/the-link-between-structural-racism-high-blood- pressure-and-black-peoples-health
