University of Massachusetts Medical School, 55 Lake Ave N, Benedict Bldg, Worcester, MA 01655, USA.
Prev Chronic Dis. 2010 Jul;7(4):A83. Epub 2010 Jun 15.
In 2006, the Massachusetts League of Community Health Centers convened a collaborative to systematically improve health care delivery for patients with diabetes in 17 community health centers. Our goal was to identify facilitators of and barriers to success reported by teams that participated in this collaborative.
The collaborative's activities lasted 13 months. At their conclusion, we interviewed participating team members. We asked about their teams' successes, challenges, and take-home messages for future collaborative efforts. We organized their responses into common themes by using the Chronic Care Model as a framework.
Themes that emerged as facilitators of success included shifting clinic focus to more actively involve patients and to promote their self-management; improving the understanding and implementation of professional guidelines; and expanding staff roles to accommodate these goals. Patient registries were perceived as beneficial but lacking adequate technical support. Other barriers were staffing and time constraints.
Cooperative efforts to improve health care delivery for people with diabetes may benefit from educating the health care team about guidelines, establishing a stronger role for the patient as part of the health care team, and providing adequate technical instruction and support for the use of clinical databases.
2006 年，马萨诸塞州社区医疗中心联盟召集了一个协作组，旨在为 17 家社区医疗中心的糖尿病患者提供更系统的医疗服务。我们的目标是确定参与该协作组的团队所报告的成功因素和障碍。
协作活动持续了 13 个月。在活动结束时，我们采访了参与团队的成员。我们询问了他们团队的成功经验、挑战以及对未来合作的收获。我们使用慢性病管理模式作为框架，将他们的回答组织成常见的主题。
成功的促进因素包括将诊所的重点转移到更积极地让患者参与并促进他们的自我管理；提高对专业指南的理解和执行能力；以及扩大员工角色以适应这些目标。患者登记册被认为是有益的，但缺乏足够的技术支持。其他障碍是人员配备和时间限制。
为改善糖尿病患者的医疗服务而进行的合作努力可能受益于为医疗团队提供有关指南的教育，为患者在医疗团队中建立更强大的角色，并为使用临床数据库提供足够的技术指导和支持。
