Deploying the chronic care model to implement and sustain diabetes self-management training programs

Linda M. Siminerio, Gretchen A. Piatt, Sharlene Emerson, Kristine Ruppert, Melissa Saul, Francis Solano, Andrew Stewart, Janice C. Zgibor

Research output: Contribution to journalArticlepeer-review

79 Scopus citations

Abstract

Purpose: The purpose of this project was to evaluate the utility of using the 6 elements of the chronic care model (CCM; health system, community, decision support, self-management support, clinical information systems, and delivery system design) to implement and financially sustain an effective diabetes self-management training (DSMT) program. Methods: The University of Pittsburgh Medical Center (UPMC) uses all elements of the CCM. Partnerships were formed between UPMC and western Pennsylvanian community hospitals and practices; the American Diabetes Association DSMT recognition program provided decision support. A clinical data repository and reorganization of primary care practices aided in supporting DSMT. The following process and patient outcomes were measured: number of recognized programs, reimbursement, patient hemoglobin A1C levels, and the proportion of patients who received DSMT in primary care practices versus hospital-based programs. Results: Using elements of the CCM, the researchers were able to gain administrative support; expand the number of recognized programs from 3 to 21; cover costs through increased reimbursement; reduce hemoglobin A1C levels (P < .0001), and increase the proportion of patients receiving DSMT through delivery in primary care (26.4% suburban; 19.8% urban) versus hospital-based practices (8.3%; P < .0001). Conclusions: The CCM serves as an effective model for implementing and sustaining DSMT programs.

Original languageEnglish
Pages (from-to)253-260
Number of pages8
JournalDiabetes Educator
Volume32
Issue number2
DOIs
StatePublished - 3 Apr 2006
Externally publishedYes

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