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Updated: Jun 13, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

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Published on: June 11, 2012

Using collaborative learning to improve diabetes care and outcomes: the VIDA project.

Alberto Barceló1, Elizabeth Cafiero, Melanie de Boer

  • 1Pan American Health Organization, Washington, DC 20037-2895, USA. barceloa@paho.org

Primary Care Diabetes
|May 19, 2010
PubMed
Summary

Improving diabetes care in Mexico: A quality improvement project using the chronic care model and breakthrough series methodology significantly enhanced glycemic control and patient outcomes in primary health centers.

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Last Updated: Jun 13, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

  • Public Health
  • Healthcare Quality Improvement
  • Chronic Disease Management

Background:

  • Diabetes prevalence in Mexico (ages 20-64) rose from 7.2% (1993) to 10.7% (2000).
  • 50% of diagnosed individuals had blood glucose levels ≥200 mg/dL, highlighting a critical public health challenge.
  • Effective diabetes care strategies are urgently needed in primary healthcare settings.

Purpose of the Study:

  • To enhance the quality of diabetes care within Mexican primary health centers.
  • To implement the chronic care model and breakthrough series (BTS) collaborative methodology.
  • To improve process and outcome measures for diabetes management.

Main Methods:

  • Ten public health centers in Xalapa and Veracruz were randomized into intervention (n=5) and usual care (n=5) groups.
  • The intervention involved implementing the chronic care model and BTS methodology over 18 months (Nov 2002 - May 2004).
  • Glycemic control (A1c) was measured pre- and post-intervention, with results adjusted for clustering and baseline values.

Main Results:

  • Good glycemic control (A1c<7%) increased from 28% to 39% in the intervention group.
  • Achievement of ≥3 quality improvement goals rose significantly from 16.6% to 69.7% (p<0.001) in the intervention group.
  • The usual care group showed a non-significant decrease in goal achievement (12.4% to 5.9%, p=0.118).

Conclusions:

  • The intervention successfully improved process and outcome measures for quality diabetes care.
  • Key elements included empowering primary care teams and engaging patients in self-management.
  • Modifications focused on self-management support, decision support, delivery system design, and clinical information systems within the chronic care model.