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利用共病诊疗实施成人糖尿病自我管理教育计划于基层医疗照护之执行。

Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments.

机构信息

The Weslaco Medical Clinic, Weslaco, Texas

出版信息

Diabetes Educ. 2011 May-Jun;37(3):381-91. doi: 10.1177/0145721711401667. Epub 2011 Mar 31.

Abstract

PURPOSE

The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes.

METHODS

A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines.

RESULTS

The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program.

CONCLUSIONS

As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

摘要

目的

本研究旨在使用慢性病护理模式和共病诊疗预约(SMA)在基层医疗中实施糖尿病自我管理教育,提供循证干预措施,以改善流程和衡量结果。

方法

在德克萨斯州南部的基层医疗环境中实施了一项质量改进项目,使用计划-执行-检查-行动循环,为成年人提供糖尿病自我管理教育。在项目启动时和此后,根据当前的实践指南,对 70 名患者进行了生物学指标评估。

结果

该项目的结果与 SMA 的益处、可持续性和可行性的文献一致。与文献中介绍的研究相比,参与 SMA 的患者人群在 A1C、自我管理技能和满意度方面的改善方面具有相似的结果。SMA 是一种创新的系统重新设计理念,有可能为患有多种慢性疾病的患者提供全面和协调的护理,同时仍然是一个高效、有效、经济上可行和可持续的项目。

结论

随着糖尿病发病率和患病率的增加,创新的护理模式可以满足对获得和利用糖尿病自我管理教育计划的需求。专注于改善慢性病结果的项目可以由初级保健环境中的医疗保健提供者复制。SMA 可以增加收入和生产力,改善疾病管理,并提高提供者和患者的满意度。

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