Results of a mixed-methods evaluation of partnerships for health: a quality improvement initiative for diabetes care
| Autor: | Susan Webster-Bogaert, Bridget L. Ryan, Amanda L. Terry, Meghan Fournie, Cathy Thorpe, Judith Belle Brown, Jann Paquette-Warren, Moira Stewart, Amardeep Thind, Sharon E. Roberts, Stewart B. Harris |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Quality management Waist Blood Pressure Audit Young Adult Diabetes mellitus Health care medicine Diabetes Mellitus Humans Glycemic Aged Aged 80 and over Glycated Hemoglobin Ontario Clinical Audit Primary Health Care business.industry Public Health Environmental and Occupational Health Partnership Practice Disease Management Middle Aged medicine.disease Quality Improvement Blood pressure Family medicine Physical therapy Female Family Practice business Body mass index |
| Zdroj: | Journal of the American Board of Family Medicine : JABFM. 26(6) |
| ISSN: | 1558-7118 |
| Popis: | Purpose: Quality improvement (QI) initiatives have been implemented to facilitate transition to a chronic disease management approach in primary health care. However, the effect of QI initiatives on diabetes clinical processes and outcomes remains unclear. This article reports the effect of Partnerships for Health, a QI program implemented in Southwestern Ontario, Canada, on diabetes clinical process and outcome measures and describes program participants9 views of elements that influenced their ability to reach desired improvements. Methods: Part of an external, concurrent, comprehensive, mixed-methods evaluation of Partnerships for Health, a before/after audit of 30 charts of patient of program physicians (n = 35) and semistructured interviews with program participants (physicians and allied health providers) were conducted. Results: The proportion of patients (n = 998) with a documented test/examination for the following clinical processes significantly improved (P ≤ .005): glycosylated hemoglobin (A1c), cholesterol, albumin-to-creatinine ratio, serum creatinine, glomerular filtration rate, electrocardiogram, foot/eye/neuropathy examination, body mass index, waist circumference, and depression screening. Data showed intensification of treatment and significant improvement in the number of patients at target for low-density lipoprotein (LDL) and blood pressure (BP) (P ≤ .001). Mean LDL and BP values decreased significantly (P ≤ .01), and an analysis of patients above glycemic targets (A1c >7% at baseline) showed a significant decrease in mean A1c values (P ≤ .01). Interview participants (n = 55) described using a team approach, improved collaborative and proactive care through better tracking of patient data, and increased patient involvement as elements that positively influenced clinical processes and outcomes. Conclusions: QI initiatives like Partnerships for Health can result in improved diabetes clinical process and outcome measures in primary health care. |
| Databáze: | OpenAIRE |
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