The Australian Primary Care Collaboratives Program: improving diabetes care

摘要: Problem Diabetes is a major, growing health problem often managed in primary care but with suboptimal control of risk factors. Design A large-scale quality improvement collaborative implemented seven waves. Setting General practices and Aboriginal medical services across Australia. Key measures for Percentage patients each service haemoglobin A1C (HbA1C), total cholesterol blood pressure at target. Strategy change Health attended three 2-day workshops, separated by 3-month activity periods followed 12 months further work. Local program managers supported teams to report plan/do/study/act (PDSA) cycles monthly. received feedback about changes their comparison wave. Effects 743 participated waves between 2004 2009 serving approximately 150 000 people diabetes. Mean numbers target HbA1c levels improved 50% from 25% baseline 38% month 18. Lipid showed similar improvement. Lessons learnt Engagement the Program results demonstrated that methodology transferable Australian care. The may reflect data recording disease coding, clinical Internal evaluation should be built into projects start facilitate improvements reporting. Enthusing, training resourcing practice appeared key rapid change. support was instrumental improvement. Early investment automatic measure collection ensured good