Assessing the implementation of the chronic care model in quality improvement collaboratives.
Health Serv Res
; 40(4): 978-96, 2005 Aug.
Article
em En
| MEDLINE
| ID: mdl-16033488
ABSTRACT
OBJECTIVE:
To measure organizations' implementation of Chronic Care Model (CCM) interventions for chronic care quality improvement (QI). DATA SOURCES/STUDYSETTING:
Monthly reports submitted by 42 organizations participating in three QI collaboratives to improve care for congestive heart failure, diabetes, depression, and asthma, and telephone interviews with key informants in the organizations. STUDYDESIGN:
We qualitatively analyzed the implementation activities of intervention organizations as part of a larger effectiveness evaluation of yearlong collaboratives. Key study variables included measures of implementation intensity (quantity and depth of implementation activities) as well as fidelity to the CCM. DATA COLLECTION/EXTRACTIONMETHODS:
We developed a CCM-based scheme to code sites' intervention activities and criteria to rate their depth or likelihood of impact. PRINCIPALFINDINGS:
The sites averaged more than 30 different change efforts each to implement the CCM. The depth ratings for these changes, however, were more modest, ranging from 17 percent to 76 percent of the highest rating possible. The participating organizations significantly differed in the intensity of their implementation efforts (p<.001 in both quantity and depth ratings). Fidelity to the CCM was high.CONCLUSIONS:
Collaborative participants were able, with some important variation, to implement large numbers of diverse QI change strategies, with high CCM fidelity and modest depth of implementation. QI collaboratives are a useful method to foster change in real world settings.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Garantia da Qualidade dos Cuidados de Saúde
/
Doença Crônica
/
Atenção à Saúde
/
Implementação de Plano de Saúde
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Sysrev_observational_studies
Limite:
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article