LCHC based its five-step hypertension care pathway on a review of the medical literature, including lessons learnt from a successful hypertension improvement effort at Virginia Mason Medical Center. LCHC based its five-step hypertension care pathway on a review of the medical literature, including lessons learnt from a successful hypertension improvement effort at Virginia Mason Medical Center. This simple visual was used consistently and ubiquitously (in communications, during meetings, posted in clinical areas) to facilitate staff alignment and understanding of the essential steps in the care pathway. BH, behavioural health; BP, blood pressure; DO, Doctor of Osteopathy; HTN, hypertension; LCHC, Lynn Community Health Center; MA, medical assistant; MD, Doctor of Medicine; MED, medical provider; NP, nurse practitioner; PA, physician assistant ; RN, registered nurse. Patrick Lee et al. BMJ Open Qual 2019;8:e000373 © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.