The Institute for Healthcare Improvement and Improving Chronic Illness Care, a national program of The Robert Wood Johnson Foundation, have both developed and adapted tools to help organizations accelerate their work to improve the care for patients with chronic conditions. In addition, many organizations have developed tools in the course of their improvement efforts — successful flowcharts, forms, instructions and guidelines for implementing key changes — and are making them available on IHI.org for others to use or adapt in their own organizations.
The tools are grouped according to the key areas of the Chronic Care Model where changes must be made to improve care for people with chronic conditions. Below are a few of these tools, but for more information on all of IHI's Chronic Conditions tools, visit: http://www.ihi.org/IHI/Topics/ChronicConditions/AllConditions/Tools/
The Chronic Care Model identifies six fundamental areas that form a system that encourages high-quality chronic disease management. Organizations must focus on these six areas, as well as develop productive interactions between patients who take an active part in their care and providers who have the necessary resources and expertise.
To assess your organization's current levels of care with respect to the six components of the Chronic Care Model, use the Assessment of Chronic Illness Care Survey.
For some quick tips on Forming a Team, Setting Aims, Establishing Measures, and Testing Changes, take a look at IHI's How to Improve page.
IHI's Frequently Asked Questions for Chronic Conditions.