Identifying Undiagnosed Hypertension Train-the-Trainer Curriculum

Identifying Undiagnosed Hypertension Train-the-Trainer Curriculum 


This curriculum was developed as a resource for quality improvement staff and trainers who support adoption, implementation and maintenance of clinical processes—especially those related to hypertension. The focus of this cirriculum is to prepare trainers to work with staff to develop policies and procedures for identifying undiagnosed or masked hypertension. Several research efforts have identified a difference of approximately 13% between expected and observed prevalence of hypertension among patient panels of large health care organizations (Clemins, Richey, Joshi, et al., 2018). Because of the known health risks related to uncontrolled hypertension, it is essential that we identify undiagnosed hypertension so we can connect patients to necessary treatment and supports.  

Through spread of this training, and evidence-based materials from the Centers for Disease Control and Prevention (CDC), we hope more clinics will implement hypertension identification and control policies and procedures; improve referral and connection to appropriate blood pressure control resources and services for patients at risk of and diagnosed with hypertension; and address accurate measuring and monitoring of blood pressure.  

Intended Audience 

The intended audience for this train-the-trainer session includes, but is not limited to, quality improvement staff, staff supervisors or trainers, medical assistant leads and community health worker supervisors. Although many of the concepts presented in this training refer to outpatient clinical settings, we believe the content could be adopted for other settings and staff.  

Goals and Purpose 

This curriculum is designed to prepare staff trainers to support their organizations in: 

  • Identifying undiagnosed hypertensive patients 
  • Calculating expected prevalence using the Million Hearts® campaign’s hypertension prevalence estimator tool using demographic and comorbidities data 
  • Incorporating undiagnosed hypertension into existing population management efforts 
  • Establishing a process/procedure for screening patients 
  • Using the electronic health record (EHR) and/or other data sources to search for patients who meet the established screening criteria 
  • Training or retraining clinical staff on appropriate blood pressure measurement techniques, including impacts of poor technique on blood pressure numbers 
  • Implementing a plan to diagnose identified patients, and connect those newly diagnosed with hypertension to necessary treatment and supports 

Available Tools and How to Use Them

All of the tools below can be used however trainers see fit.

  • Curriculum Outline Document - This document outlines the training, giving a brief description of the purpose of each section along with suggested activities and suggested handouts, as well as references for the materials.

  • Editable PowerPoint slides for Trainers -  These slides can be used for training trainers, as well as modifying for trainers to bring back to their organizations. Slides include notes for context and activity descriptions. 

  • Action Planning Template - This template is intended to be a place where trainers can help participants make intentional plans for how to incorporate their learning from the training into their work and how they will bring content back to their teams.  

  • The supplemental videos (below)- These videos are meant to supplement the training, but can be used in any way that is helpful to those wanting to learn or teach content related to undiagnosed hypertension. Slides in the training reference when to play videos that are meant to accompany specific sections.


Please contact Rebekah Bally-Larkin


Why Undiagnosed Hypertension? 

In just three minutes, this video sums-up the importance of focusing on identifying undiagnosed hypertension as part of your overall hypertension control efforts with expert opinion from Dr. Evan Saulino.

The Importance of Proper Blood Pressure Measurement Technique 

Hear Dr. Evan Saulino's perspective on why it is important to regularly review proper blood pressure measurement technique for all staff.

Setting up Self-measured blood pressure (SMBP) monitoring for your Patients 

Listen to Dr. Evan Saulino and Dr. Sarah Woolsey share their pitch for why it is important to offer self-measured blood pressure monitoring to your patients. This video will also outline how to adopt an SMBP program and includes links to a few helpful resources.

Engaging Leadership 

This video offers strategies for engaging leadership and garnering buy-in for your quality improvement idea using the example of identifying undiagnosed hypertension.