Development and Implementation of a Collaborative Team Care Model for Effective Insulin Use in an Academic Medical Center Primary Care Network. (July 2017)

• Record Type: Journal Article
• Authors: Eisenstat, Stephanie A.; Chang, Yuchiao; Porneala, Bianca C.; Geagan, Elizabeth; Wilkins, Gianna; Chase, Barbara; O'Keefe, Sandra M.; Delahanty, Linda M.; Atlas, Steven J.; Zai, Adrian H.; Finn, David; Weil, Eric; Wexler, Deborah J.
• Is Part Of: American journal of medical quality. Volume 32:Number 4(2017:Jul./Aug.)
• Page Start: 397
• Page End: 405
• Publication Date: 2017-07
• Subjects: diabetes quality improvement -- effective insulin use -- care redesign -- patient-centered medical home -- accountable care organization -- insulin treatment -- type 2 diabetes; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860616651715
• Languages: English
• ISSNs: 1062-8606

Abstract

Improving glycemic control across a primary care diabetes population is challenging. This article describes the development, implementation, and outcomes of the Diabetes Care Collaborative Model (DCCM), a collaborative team care process focused on promoting effective insulin use targeting patients with hyperglycemia in a patient-centered medical home model. After a pilot, the DCCM was implemented in 18 primary care practices affiliated with an academic medical center. Its implementation was associated with improvements in glycemic control and increase in insulin prescription longitudinally and across the entire population, with a >1% reduction in the proportion of glycated hemoglobin >9% at 2 years after the implementation compared with the 2 years prior ( P < .001). Facilitating factors included diverse stakeholder engagement, institutional alignment of priorities, awarding various types of credits for participation and implementation to providers, and a strong theoretical foundation using the principles of the collaborative care model.