Lessons from Chronic Disease Collaboratives July 2005

Chronic Disease Collaboratives Similar to SDPI CGP Demonstration Projects Number of health programs come together Focus on improving/implementing care for a specific condition – gaps between current and best practice – room to improve Team-based, multidisciplinary Evidence-based Planning year – developing actual intervention Sharing among programs along the way Specific, measurable goals/targets Ongoing evaluation Eventual dissemination of findings

Chronic Disease Collaboratives Goals Assess the extent to which health programs implement the changes in their systems Degree to which they show improvements in processes and impact/outcomes Environmental, organizational, team and individual factors associated with success Other Which elements of activities have greatest impact Which patients benefit the most Cost of activities

Chronic Disease Collaboratives Examples IHI Breakthrough Series Collaboratives HRSA Quality Improvement Collaboratives Numerous other organizations Often based on the Chronic Care Model – changes in multiple levels in health care system to address chronic disease Problem – few able to demonstrate that the improvements they make are greater than baseline or secular trends happening in non-participating programs

Chronic Disease Collaboratives Lessons learned Teams vary in degree of their implementation Greater degree of implementation --- better impact/outcomes

Chronic Disease Collaboratives Lessons learned Teams vary in their effectiveness More effective teams have better impact/outcomes Key attributes of effective teams Strong leadership, team champion Work well, effectively, continuity of staff/providers Support of senior leadership, home organization important Goals, expectations clear, benefits to participation clear, motivation Resources, time, support needed Understand the importance of evaluation, data collection

Chronic Disease Collaboratives Lessons learned Evaluation Most collaborative efforts just measure process data Measurement of outcomes is usually before vs. after Without comparison, don’t know if improvements are due to activities, or would have occurred anyway Secular trends – changes in awareness, treatment, guidelines over time result in changes even without new activities Growing recognition of the need to compare results with those not participating