Improving and Sustaining Diabetes Care in Community Health Centers With the Health Disparities Collaboratives

Chin, Marshall H.; Drum, Melinda L.; Guillen, Myriam; Rimington, Ann; Levie, Jessica; Kirchhoff, Anne C.; Quinn, Michael T.; Schaefer, Cynthia T.

doi:10.1097/mlr.0b013e31812da80e

Cited by 115 publications

(135 citation statements)

References 23 publications

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“…27 Among CHC visits, 20% were made by AfricanAmericans, in comparison to other estimates of approximately 25%. 28 Consequently, our findings may not be generalizable to the most vulnerable African-American patients, who typically receive fewer health services.…”

Section: Discussionmentioning

confidence: 51%

National Prevalence of Lifestyle Counseling or Referral Among African-Americans and Whites with Diabetes

et al. 2008

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Section: Discussionmentioning

confidence: 51%

National Prevalence of Lifestyle Counseling or Referral Among African-Americans and Whites with Diabetes

et al. 2008

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“…13,14 Patients with diabetes typically provide about 95% of their own care, 15 and effective diabetes self-management has been shown to significantly improve health outcomes. 16,17 The complications of diabetes can be often be reduced with appropriate health care and education in self-management.…”

Section: Introductionmentioning

confidence: 99%

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Madden

Tomsik

Terchek

et al. 2011

Journal of the National Medical Association

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Objective To determine how medically uninsured patients with limited material resources successfully manage diabetes. Methods Clinicians at 5 safety net practices enrolled uninsured adult patients (N=26) with prior diagnosis of diabetes for 6 months or longer. Patients were interviewed about enabling factors, motivations, resources, and barriers. Chart reviews and clinician surveys supplemented interview data. Interview, survey, and chart review data were analyzed and findings were summarized. Results Two distinct groups of patients were investigated: 1) “successful,” defined as those with an HbA1c of ≤7% or a recent improvement of at least 2% (n=17); and 2) “unsuccessful,” defined as patients with HbA1c of ≥9% (n=9) without recent improvement. In comparison to unsuccessful patients, successful patients more often reported having friends or family with diabetes, sought information about the disease, used evidence-based self-management strategies, held an accurate perception of their own disease control, and experienced “turning point” events that motivated increased efforts in disease management. Conclusions Uninsured safety net patients who successfully managed diabetes learned from friends and family with diabetes and leveraged disease-related events into motivational turning points. It may be beneficial for clinicians to incorporate social learning and motivational enhancement into diabetes interventions to increase patients’ motivation for improved levels of self-management.

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“…While a number of studies have explored interinstitutional collaborations to improve care, [11][12][13] there has been little research to identify the attributes that contribute to innovation and improvement in learning, or the role of intrainstitutional collaboration in contributing to improvement at the interface of clinical care and learning. There is benefit in better understanding common attributes of these settings and the process by which some programs and institutions achieve innovation and improvement in the learning environment.…”

Section: Discussionmentioning

confidence: 99%

Institutional Attributes Associated With Innovation and Improvement: Results of a Multisite Study

Philibert¹,

Johnston²,

Hruska³

et al. 2010

Journal of Graduate Medical Education

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Background To date, no studies have explored why some teaching hospitals and health systems appear to offer a more fertile environment for innovation and improvement in the learning environment. As a consequence, little is known about the role of organizational attributes and culture in fostering innovation and improvements in settings where residents learn and participate in care, though these have been studied extensively in the general literature on organizations. Aims The goals of our study entailed (1) gathering ground-level observations on processes and common attributes; (2) disseminating this information for adoption and adaptation; and (3) exploring whether the current accreditation model may present barriers to institution- and program-level innovation. Methods We conducted a qualitative study of 4 institutions, successful in innovation and improvement in their learning environment, and sought to replicate the findings with a second group of 5 institutions. Results Three themes emerged from the interviews and site visits of the participants in the alpha phase: (1) a structure and culture that promote integration and inclusion; (2) a recognition of the value of resident education to the institution; and (3) a learning organization rooted in the extensive use of data and ongoing change, improvement, and innovation. Conclusions Some of the concepts identified in our small sample of “innovative” institutions could be relatively easily adopted or adapted by others that seek to enhance innovation and improvement in the learning environment. In contrast, the structural factors that characterized 3 of the 4 alpha participants, particularly the organization and compensation of faculty, may not be generalizable to many other institutions.

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Improving and Sustaining Diabetes Care in Community Health Centers With the Health Disparities Collaboratives

Abstract: Diabetes care and outcomes improved in HCs during the first 4 years of the HDC quality improvement collaborative. More intensive interventions helped marginally.

Cited by 115 publications

References 23 publications

National Prevalence of Lifestyle Counseling or Referral Among African-Americans and Whites with Diabetes

National Prevalence of Lifestyle Counseling or Referral Among African-Americans and Whites with Diabetes

Keys to Successful Diabetes Self-management for Uninsured Patients: Social Support, Observational Learning, and Turning Points: A Safety Net Providers' Strategic Alliance Study

Institutional Attributes Associated With Innovation and Improvement: Results of a Multisite Study

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