Assessing the Implementation of the Chronic Care Model

Daniel J. Epstein Department of Industrial and Systems Engineering Seminar: "Assessing the Implementation of the Chronic Care Model"Dr. Shinyi WuAssociate Director, Roybal Center for Health Policy Simulation, RAND CorporationABSTRACT: Chronic disease is the primary driver of demand for healthcare in the United States, but efforts to meet this demand that rely on the traditional acute care approach to treatment are costly and, often, ineffective. To address this problem, the MacColl Institute for Healthcare Improvement has developed the Chronic Care Model (CCM) to encourage an organized, proactive approach to care for individuals with chronic illnesses. The model proposes changes in six essential elements of a healthcare system: the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Because the model recommends changes in multiple components of complex systems, implementation is a significant challenge. Given this challenge, assessments of implementation are needed; only by understanding the details of what was actually done can change agents account for failure to achieve expected results or identify factors that provide the most leverage in achieving successful outcomes. In this talk, Dr. Wu will discuss two studies examining implementation of the CCM. The first, conducted in the context of a national evaluation of chronic care collaboratives, advances the study of implementation by defining a set of change activities within each of the six areas specified in the CCM and a coding system that can be used to specify three aspects of implementation: how many changes were implemented, depth of implementation, and fidelity to the CCM for the PDCA cycles tested. Relying on this system, the research team found that the extent and quality of implementation varied across the participating organizations and identified factors that accounted for the variation. The second study, now in progress, involves development of a toolkit and a practice coaching method to facilitate implementation of the CCM in safety net clinics, as these organizations may not have access to chronic care collaboratives or may find the requirements of participating in a collaborative (e.g., registration fees, travel costs, time away from work) burdensome. Incorporating models such as the CCM into the teaching and practice of industrial engineering would enable IEs to participate effectively in interdisciplinary efforts to improve the operation of healthcare systems. WEDNESDAY, APRIL 25, 2006, GERONTOLOGY BUILDING (GER) ROOM 309, 10:00-11:00 AM

Location: Ethel Percy Andrus Gerontology Center (GER) - 309

Audiences: Everyone Is Invited

Contact: Georgia Lum