Martin John P, Aboubechara Natalie
Complete Care, Kaiser Permanente Southern California Region, Regional Guidelines Development Lead Physician Kaiser Permanente, Los Angeles Medical Center, 4950 Sunset Blvd, Module 6c, Los Angeles, CA, 90027, USA.
Pharmacist Evidence Analyst and Strategist Drug Information Services, Kaiser Permanente, 1800 Harrison St., Ste 1301, Oakland, CA, 94612, USA.
Curr Diab Rep. 2017 Sep;17(9):79. doi: 10.1007/s11892-017-0897-9.
The purpose of this review was to provide an overview of the Kaiser Permanente Southern California (KPSC) Complete Care management strategy.
The KPSC Complete Care program allows members of care management teams to coordinate the administration of care for patients with diabetes. This program encompasses teams of physicians, physician assistants, pharmacists, nurse practitioners, registered nurse (RN) care managers, office-based RNs, health educators, and many others to contribute to the glycemic and overall health outcomes for our patients with diabetes. The 2016 Kaiser Permanente National Clinical Practice Guideline for Adult Diabetes Clinician Guide and the supplemental KPSC Treat-to-Target (TTT) Type 2 Diabetes A1c Control algorithm are used to assist KPSC clinicians by providing guidance for shared decision-making, as well as the selection and sequence of appropriate pharmacological treatment. Collaboration with pharmacy through the Formulary and the Drug Utilization Action Team (DUAT) allows the organization to manage member resources while consistently offering patients the highest quality and value health care possible. Recent technology integrations have also contributed to the success of the program.
本综述旨在概述南加州凯撒医疗集团（KPSC）的全病程管理策略。
KPSC全病程管理项目使管理团队成员能够协调糖尿病患者的护理管理。该项目涵盖了医生、医师助理、药剂师、执业护士、注册护士（RN）护理经理、门诊RN、健康教育工作者等团队，共同致力于改善糖尿病患者的血糖及整体健康状况。2016年凯撒医疗集团成人糖尿病临床医生指南及补充性的KPSC达标治疗（TTT）2型糖尿病A1c控制算法，通过为共同决策提供指导以及选择和安排适当的药物治疗，来协助KPSC临床医生。通过药品目录和药物利用行动小组（DUAT）与药房合作，使该机构能够管理会员资源，同时始终为患者提供尽可能高质量和高价值的医疗服务。近期的技术整合也推动了该项目的成功。
