July 2014 | Improving Diabetes Care
Monday, July 14, 2014
Improving Diabetes Care

In the United States, approximately 25.8 million people (8.3 percent of the population) have Type II diabetes. To combat this public health threat, AF4Q communities work each day to improve the quality of care for diabetes.

Today's edition of Spotlight showcases some examples of this work.

Composite Measures: A New Gold Standard in Diabetes Care

Making sure those with diabetes receive optimal care is as complex as the disease itself. Many different indicators of health should be monitored on a regular basis. The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible.

MN Community Measurement, leader of the Aligning Forces initiative in Minnesota, developed the D5 composite measure to set guidelines for providers and consumers on optimal diabetes care. A composite score is a combined metric useful in assessing quality of care. Synthesizing indicators of good diabetes management has helped simplify the challenges of chronic care management while improving efficiency and performance.

“We aimed for the completeness of care because we really wanted to create an impact around cardiovascular risk for our diabetes patients," explained Jim Chase, president of MN Community Measurement.

One Size Doesn't Fit All

African Americans with diabetes in Wisconsin are four times more likely than Caucasians with diabetes to have an amputation, according to 2010 Dartmouth Atlas data. The Wisconsin Collaborative for Healthcare Quality (WCHQ), leader of the Aligning Forces for Quality initiative in Wisconsin, is using a multi-pronged intervention approach to reduce racial disparities in care.

WCHQ has partnered with Wheaton Franciscan Healthcare, a non-profit integrated health care system in Wisconsin, to identify and remove barriers to diabetes management. Why weren’t patient needs being met? Said Cindy Schlough, director of strategic partnerships with WCHQ, “The one-size fits all approach doesn’t fit every population. We need to meet patients where they are.” Disparities in care aren’t simply the result of one factor, like language preference.

Small Providers, Better Care

The citizens of Memphis, TN, suffer from Type II diabetes rates above the national average. The average rate of diabetes prevalence in the United States is 8.3 percent, and in Shelby County the average rate is 12 percent, according to the County Health Rankings. Diabetes and pre-diabetes contribute to the majority of premature deaths in Tennessee, according to a recent study from the University of Tennessee Health Science Center.

And at the front lines of care, primary care physicians in Memphis tackle treating patients with diabetes with the help of Project Better Care, a program from Healthy Memphis Common Table (HMCT), leader of Aligning Forces for Quality in this community. The guiding principle of Project Better Care is that patients are best served by preventive care. Both quality of care and patient experience are maximized by comprehensive chronic care management, rather than visits to the emergency room. To support these smaller Memphis practices, Project Better Care uses the Chronic Care Model to create readiness for becoming a patient-centered medical home.

Aligning Forces for Quality (AF4Q) is the Robert Wood Johnson Foundation’s (RWJF) signature effort to lift the overall quality of health care in targeted communities, reduce racial and ethnic disparities in health care and provide models for national reform. Alliance teams represent the people who get care, give care, and pay for care.
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