Adventist Health Medical Group supports patients with diabetes
Incorporates best practices from Collaboratives and Chronic Care Model
Problem/Challenge/Opportunity
During the 20th century, the leading causes of death changed from infectious diseases to chronic diseases. Today, heart disease, cancer, stroke, diabetes, and lung disease are the leading causes of death. Chronic diseases account for seven out of every 10 deaths in Oregon. As the "Baby Boom" generation ages, the number of Oregonians affected by chronic diseases will escalate rapidly, increasing healthcare costs, accounting for 75 percent of all healthcare spending.
The current health system, based on an acute care model, is not designed to optimally manage chronic illness. Despite best intentions and clinical knowledge, most primary care practices are not organized to help patients with chronic conditions live well and avoid or delay complications and suffering.
Project Overview
The Chronic Care Model (CCM), developed by the Improving Chronic Illness Care program with funding from The Robert Wood Johnson Foundation, offers proven, systems-based approaches to bridge the gap between what we know is good care for people with chronic conditions and the care most medical practices currently provide. Adventist Health Medical Group is applying CCM principles with support from the Oregon Diabetes Collaboratives-two yearlong, multiclinic projects for sharing and testing change ideas in actual practice.
Since 2001, OMPRO has sponsored these Collaboratives based on the Institute for Healthcare Improvement (IHI) Breakthrough Series Collaborative Model. Adventist Health has participated in both and has successfully integrated the Chronic Care Model and best practices in its clinics.
Helping patients become partners in managing their condition is a key element of the CCM. Adventist Health recently launched a new "group visit" program for patients with diabetes. The patient-focused visit provides an opportunity for patients to interact with and learn from practitioners and other patients with diabetes. The visit provides patients expanded time for education, such as nutrition and fitness counseling, in addition to one-on-one time with their physicians. The group visit also allows patients to involve family members or caregivers in understanding their disease and how to manage it.
"The Adventist Health teams have worked hard and have been major contributors to both Oregon Diabetes Collaboratives," says David Shute, MD, OMPRO medical director. "They bring energy, enthusiasm, and a passion to improve the care of their patients. They willingly share their successes and help other participants overcome their barriers. Adventist Health is successfully getting patients more engaged in the care of their diabetes."
Adventist Health's Diabetes Collaborative teams worked with their existing system-wide electronic medical record to create "Best Care Alerts," which prompt clinicians when patients with diabetes are due for routine tests. According to Joyce Caramella, RN, BA, CPHQ, Adventist Health quality improvement coordinator, regardless of the patient's reason for visiting the clinic, physicians focus on ongoing diabetes care.
The Collaborative format promotes improved care by enabling providers to learn from other's successes and failures. "It's a wonderful energizing experience to talk to others and share best practices," says Caramella. "It makes you want to come back and do more."
Community/Facility Background
Adventist Health Medical Group is part of Adventist Health, a not-for-profit healthcare system affiliated with the Seventh-day Adventist Church. In Portland, there are 17 Adventist Health primary care medical clinics and one hospital. Adventist Health physicians treat more than 4,000 people with diabetes. OMPRO and Oregon healthcare providers are excited about highlighting innovative work being done in the state.
