Tags

Type your tag names separated by a space and hit enter

A population-based approach to diabetes management in a primary care setting: early results and lessons learned.
Eff Clin Pract. 1998 Aug-Sep; 1(1):12-22.EC

Abstract

OBJECTIVE

To determine the effect of a multifaceted program of support on the ability of primary care teams to deliver population-based diabetes care.

DESIGN

Ongoing evaluation of a population-based intervention.

SETTING/PARTICIPANTS

Group Health Cooperative of Puget Sound, a staff model HMO in which more than 200 primary care providers treat approximately 15,000 diabetic patients.

INTERVENTION

A program of support to improve the ability of primary care teams to deliver population-based diabetes care was implemented. The elements of the program are based on an integrated model of well-validated components of delivery of effective care to chronically ill populations. These elements have been introduced since the beginning of 1995, and some aspects of the program were pilot-tested in a few practice sites before being implemented throughout the organization. The program elements include 1) a continually updated on-line registry of diabetic patients; 2) evidence-based guidelines on retinal screening, foot care, screening for microalbuminuria, and glycemic management; 3) improved support for patient self-management; 4) practice redesign to encourage group visits for diabetic patients in the primary care setting; and 5) decentralized expertise through a diabetes expert care team (a diabetologist and a nurse certified diabetes educator) seeing patients jointly with primary care teams.

MAIN OUTCOME MEASURES

Patient and provider satisfaction through existing system-wide measurement processes; process measures, health outcomes, and costs are tracked continuously.

RESULTS

Patient and provider satisfaction have improved steadily. Interest in and use of the electronic Diabetes Registry have grown considerably. Rates of retinal eye screening, documented foot examinations, and testing for microalbuminuria and hemoglobin A1c have increased substantially.

CONCLUSIONS

Providing support to primary care teams in several key areas has made a population-based approach to diabetes care a practical reality in the setting of a staff model HMO. It may be an important mechanism for improving standards of care for many diabetic patients.

Authors+Show Affiliations

Group Health Cooperative of Puget Sound, Seattle, WA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10345254

Citation

McCulloch, D K., et al. "A Population-based Approach to Diabetes Management in a Primary Care Setting: Early Results and Lessons Learned." Effective Clinical Practice : ECP, vol. 1, no. 1, 1998, pp. 12-22.
McCulloch DK, Price MJ, Hindmarsh M, et al. A population-based approach to diabetes management in a primary care setting: early results and lessons learned. Eff Clin Pract. 1998;1(1):12-22.
McCulloch, D. K., Price, M. J., Hindmarsh, M., & Wagner, E. H. (1998). A population-based approach to diabetes management in a primary care setting: early results and lessons learned. Effective Clinical Practice : ECP, 1(1), 12-22.
McCulloch DK, et al. A Population-based Approach to Diabetes Management in a Primary Care Setting: Early Results and Lessons Learned. Eff Clin Pract. 1998 Aug-Sep;1(1):12-22. PubMed PMID: 10345254.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A population-based approach to diabetes management in a primary care setting: early results and lessons learned. AU - McCulloch,D K, AU - Price,M J, AU - Hindmarsh,M, AU - Wagner,E H, PY - 1999/5/27/pubmed PY - 1999/5/27/medline PY - 1999/5/27/entrez SP - 12 EP - 22 JF - Effective clinical practice : ECP JO - Eff Clin Pract VL - 1 IS - 1 N2 - OBJECTIVE: To determine the effect of a multifaceted program of support on the ability of primary care teams to deliver population-based diabetes care. DESIGN: Ongoing evaluation of a population-based intervention. SETTING/PARTICIPANTS: Group Health Cooperative of Puget Sound, a staff model HMO in which more than 200 primary care providers treat approximately 15,000 diabetic patients. INTERVENTION: A program of support to improve the ability of primary care teams to deliver population-based diabetes care was implemented. The elements of the program are based on an integrated model of well-validated components of delivery of effective care to chronically ill populations. These elements have been introduced since the beginning of 1995, and some aspects of the program were pilot-tested in a few practice sites before being implemented throughout the organization. The program elements include 1) a continually updated on-line registry of diabetic patients; 2) evidence-based guidelines on retinal screening, foot care, screening for microalbuminuria, and glycemic management; 3) improved support for patient self-management; 4) practice redesign to encourage group visits for diabetic patients in the primary care setting; and 5) decentralized expertise through a diabetes expert care team (a diabetologist and a nurse certified diabetes educator) seeing patients jointly with primary care teams. MAIN OUTCOME MEASURES: Patient and provider satisfaction through existing system-wide measurement processes; process measures, health outcomes, and costs are tracked continuously. RESULTS: Patient and provider satisfaction have improved steadily. Interest in and use of the electronic Diabetes Registry have grown considerably. Rates of retinal eye screening, documented foot examinations, and testing for microalbuminuria and hemoglobin A1c have increased substantially. CONCLUSIONS: Providing support to primary care teams in several key areas has made a population-based approach to diabetes care a practical reality in the setting of a staff model HMO. It may be an important mechanism for improving standards of care for many diabetic patients. SN - 1099-8128 UR - https://www.unboundmedicine.com/medline/citation/10345254/A_population_based_approach_to_diabetes_management_in_a_primary_care_setting:_early_results_and_lessons_learned_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -