![]() Organizations in the first collaborative paid a flat fee of $12,000 to participate, whereas the second collaborative (run by Qualis, the Washington State Quality Improvement Organization and the Washington State Department of Health) cost $200 per attendee per session. The first collaborative in 1999 was run by the Institute for Healthcare Improvement (IHI) and had participants from the Eastern, Western, and Southern regions of the United States, whereas the second in 2001 was limited to organizations from the State of Washington. The intervention is a series of 3 learning sessions and a final meeting designed to help organizations implement the CCM for diabetes care. We ask: Is exposure to a CCM collaborative intervention associated with improved cardiovascular disease risk for patients with diabetes? 23, 25, 27 – 29 In light of this, we conducted a multicenter evaluation of a collaborative intervention to implement the CCM for diabetes care. 26, 27 However, there have been few controlled trials evaluating the effectiveness of these interventions. 26 Collaborative interventions, also termed as Breakthrough Series, have been conducted for hundreds of teams addressing multiple clinical conditions. 25Ī collaborative intervention is a method used to help health care organizations apply continuous quality improvement techniques and affect organizational change. 18, 22 – 24 Less is known about implementing the model as a whole and its impact on long-term cardiovascular disease risk factors. 20, 21 The components of the CCM have been shown to be effective for improving certain process measures. 19 The chronic care model (CCM) is a framework for managing chronic illness, which facilitates planning and coordination among providers while helping patients to play an informed role in managing their own care. Translating proven therapies and interventions into routine practice and measuring change in population level health is not easy. 17 A metaanalysis examining interventions to improve care for patients with diabetes found that studies rarely assessed the impact on patient outcomes. ![]() 9, 11 – 16 However, less is known about how to translate these clinical research findings into real-world practice. 1 – 5 Efficacious therapies for the treatment of patients with diabetes have long been available, 6 – 10 and evidence from randomized controlled trials shows that intensive use of these therapies can reduce the burden of disease. Persons with type-2 diabetes mellitus have a two- to fourfold increased risk of myocardial infarction and sudden death compared to persons without diabetes, and cardiovascular disease accounts for roughly half of all deaths in people with diabetes.
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