Assessing Chronic Illness Care for Diabetes in Primary Care Clinics

Authors: Kaissi, Amer A.; Parchman, Michael

Source: Joint Commission Journal on Quality and Patient Safety, Volume 32, Number 6, June 2006 , pp. 318-323(6)

Publisher: Joint Commission Resources

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Abstract:

Background: The Chronic Illness Care model suggests that six structural dimensions of primary care teams are important in improving the quality of diabetes care. A study was conducted to assess the degree to which these dimensions, as represented in the Assessment of Chronic Illness Care (ACIC) survey, are implemented in primary care practices and to examine their relationship with selected quality of care process measures for Type 2 diabetes.

Methods: The survey was completed in 20 primary care clinics (30 patients in each clinic) by caregivers, administrative, staff, and an external observer.

Results: Overall, administrative staff were more likely to rate their clinics higher on each structural dimension in the ACIC survey than caregivers or the external observer. The observer's and the caregivers' assessments were more consistently correlated with quality of care measures than were the administrative staff assessments. Decision support, and to a lesser degree delivery system design and self-management, were most frequently correlated with quality of care measures.

Discussion: Redesigning primary care practices to improve the quality of diabetes care requires accurate assessment of the structures of care directly related to quality measures. A version of the ACIC tool tailored to diabetes management can be used to examine structural dimensions in primary care clinics but may be more valid if completed by caregivers or an independent observer than by administrative staff.

Document Type: Research article

Publication date: 2006-06-01

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Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

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Assessing Chronic Illness Care for Diabetes in Primary Care Clinics

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