Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement

Bonomi, Amy E.; Wagner, Edward H.; Glasgow, Russell E.; VonKorff, Michael

doi:10.1111/1475-6773.00049

Cited by 333 publications

(377 citation statements)

References 50 publications

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“…Implementation of the CCM was measured by the Assessment of Chronic Illness Care (ACIC) Instrument. The ACIC is a previously validated instrument 10 , which evaluates success in implementing 7 key components of the CCM-delivery system design, decision support, clinical information systems, patient self-management, integration, healthcare system organization, and community linkages. At the beginning, in the middle and at the end of the initiatives, the residencies used the ACIC to self-evaluate implementation and application of each of the components of the CCM.…”

Section: Study Of the Intervention And Methods Of Evaluationmentioning

confidence: 99%

“…The initiatives employed the Institute for Healthcare Improvement Breakthrough Series Collaborative strategy [9][10][11] to learn and implement the CCM. Over the course of the Collaboratives, participating residency program teams met together for three, two-day learning sessions, and one all-day virtual web-mediated meeting.…”

Section: Residency Practices and Their Patientsmentioning

confidence: 99%

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A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

et al. 2010

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BACKGROUND: There is a gap between the need for patient-centered, evidence-based primary care for the large burden of chronic illness in the US, and the training of resident physicians to provide that care. OBJECTIVE: To improve training for residents who provide chronic illness care in teaching practice settings. DESIGN: US teaching hospitals were invited to participate in one of two 18-month Breakthrough Series Collaboratives-either a national Collaborative, or a subsequent California Collaborative-to implement the Chronic Care Model (CCM) and related curriculum changes in resident practices. Most practices focused on patients with diabetes mellitus. Educational redesign strategies with related performance measures were developed for curricular innovations anchored in the CCM. In addition, three clinical measures-HbA1c <7%, LDL <100 mg/dL, and blood pressure ≤130/80-and three process measures-retinal and foot examinations, and patient self-management goals-were tracked. PARTICIPANTS: Fifty-seven teams from 37 self-selected teaching hospitals committed to implement the CCM in resident continuity practices; 41 teams focusing on diabetes improvement participated over the entire duration of one of the Collaboratives. INTERVENTIONS: Teaching-practice teams-faculty, residents and staff-participated in Collaboratives by attending monthly calls and regular 2-day face-to-face meetings with the other teams. The national Collaborative faculty led calls and meetings. Each team used rapid cycle quality improvement (PDSA cycles) to implement the CCM and curricular changes. Teams reported education and clinical performance measures monthly. RESULTS: Practices underwent extensive redesign to establish CCM elements. Education measures tracked substantial development of CCM-related learning. The clinical and process measures improved, however inconsistently, during the Collaboratives. CONCLUSIONS: These initiatives suggest that systematic practice redesign for implementing the CCM along with linked educational approaches are achievable in resident continuity practices. Improvement of clinical outcomes in such practices is daunting but achievable.

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Section: Study Of the Intervention And Methods Of Evaluationmentioning

confidence: 99%

Section: Residency Practices and Their Patientsmentioning

confidence: 99%

A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

et al. 2010

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“…Additionally, as part of the formative evaluation process, in which 6-monthly reports were provided to the project Steering Committee, a range of staff including hospital department managers, community health agency CEOs, care facilitators, nursing staff and patients were regularly interviewed and completed questionnaires that included items related to concepts in the Improving Chronic Illness Care Model (Robert Wood Johnson Foundation and MacColl Institute of Healthcare Innovation) 27 and elements from the Assessment of Chronic Illness Care (ACIC). 28 A basic cost-saving analysis was conducted to assess the financial implications of the project. Project costs were derived from the expenditure reported in the project budget.…”

Section: Models Of Carementioning

confidence: 99%

Integrated care facilitation for older patients with complex health care needs reduces hospital demand

Bird

Kurowski²,

Dickman³

et al. 2007

Aust. Health Review

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Objective: The evaluation of a new model of care for older people with complex health care needs that aimed to reduce their use of acute hospital services. Method:Older people (over 55 years) with complex health care needs, who had made three or more presentations to a hospital emergency department (ED) in the previous 12 months, or who were identified by community health care agencies as being at risk of making frequent ED presentations, were recruited to the project. The participants were allocated a "care facilitator" who provided assistance in identifying and accessing required health care services, as well as education in aspects of self management. Data for the patients who had been participants on the project for a minimum of 90 days (n = 231) were analysed for their use of acute hospital services (ED presentations, admissions and hospital bed-days) for the period 12-months pre-recruitment and postrecruitment. A similar analysis on the use of hospital services was conducted on the data of patients who were eligible and who had been offered participation, but who had declined (comparator group; n = 85).Results: Post recruitment, the recruited patients displayed a 20.8% reduction in ED presentations, a 27.9% reduction in hospital admissions, and a 19.2% reduction in bed-days. By comparison, the patients who declined recruitment displayed a 5.2% increase in ED presentations, a 4.4 % reduction in hospital admissions, and a 15.3% increase in inpatient bed-days over a similar timeframe. Conclusion

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“…This project is known as ABCD (Audit and Best Practice in Chronic Disease), and includes an assessment of the quality of chronic illness care systems across six domains: community resources and policies, health system organisation, self-management support, delivery system design, decision support and clinical information systems (Bonomi et al, 2002), as well as an assessment of the process of care and health outcome measures.…”

Section: Pcds Implementation and Primary Health Carementioning

confidence: 99%

The Northern Territory Preventable Chronic Disease Strategy - promoting an integrated and life course approach to chronic disease in Australia

Weeramanthri¹,

Hendy²,

Connors³

et al. 2003

Aust. Health Review

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Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement

Cited by 333 publications

References 50 publications

A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

Integrated care facilitation for older patients with complex health care needs reduces hospital demand

The Northern Territory Preventable Chronic Disease Strategy - promoting an integrated and life course approach to chronic disease in Australia

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