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Quality improvement in chronic illness care: a collaborative approach.
E H Wagner1, R E Glasgow, C Davis
1MacColl Institute for Healthcare Innovation, Center for Health Studies, Group Health Cooperative of Puget Sound, 1730 Minor Ave, Suite 1290, Seattle, WA, USA. wagner.e@ghc.org; www.improvingchroniccare.org
The Joint Commission Journal on Quality Improvement
|February 28, 2001
Summary
The Breakthrough Series (BTS) collaborative model improved diabetes care quality in healthcare organizations. Community health centers showed significant gains, demonstrating the model's feasibility across diverse settings.
Area of Science:
- Healthcare Management
- Quality Improvement Science
- Chronic Disease Management
Background:
- Diabetes care quality remains suboptimal despite advancements.
- The Breakthrough Series (BTS) collaborative model, utilizing the Chronic Care Model, was implemented to enhance diabetes care.
- 26 healthcare organizations participated in this initiative.
Purpose of the Study:
- To evaluate the effectiveness of the BTS collaborative model in improving diabetes care.
- To describe the process, content, and organizational characteristics of participating sites.
- To assess system-level changes and their impact on care processes and clinical outcomes.
Main Methods:
- A descriptive, pre-post study design was employed over 13 months (August 1998-September 1999).
- The BTS integrated system changes from the Chronic Care Model, rapid cycle improvement, and evidence-based content.
- Data were collected through chart reviews and self-reports from participating teams.
Main Results:
- 23 of 26 participating organizations completed the program.
- Improvements in care processes and clinical outcomes were observed, based on data from chart reviews and self-reports.
- Organizations with fewer resources, such as community health centers, demonstrated substantial improvements.
Conclusions:
- The BTS collaborative model proved to be a feasible method for enhancing the quality of care for chronic illnesses.
- The success of the initial diabetes BTS led to its replication for other conditions like heart failure, depression, and asthma in over 50 health systems.
- The model is adaptable across various healthcare organizations and multiple chronic conditions.