HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: dc07-1515v1 31/1/57    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation Social Bookmarking                What's this?

Five-Year Impact of a Continuous Quality Improvement Effort Implemented by a Network of Diabetes Outpatient Clinics

Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy

Address correspondence and reprint requests to Antonio Nicolucci, MD, Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale, 66030 S. Maria Imbaro (CH), Italy. E-mail: nicolucci{at}negrisud.it

OBJECTIVE—To evaluate the impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics in Sicily, Italy.

RESEARCH DESIGN AND METHODS—Twenty-two clinics adopted the same electronic medical record system. Process and intermediate outcomes indicators were identified and software was developed, enabling the extraction of the information needed for the profiling of quality of care. Data were centrally analyzed anonymously every year, and results were discussed in meetings with the participants. The performances of the different centers were ranked against the "best performers," and the reasons for variation were discussed.

RESULTS—From 2001 to 2005, a total of 26,782 patients aged 18 years have been seen in the participating clinics. Rates of monitoring of A1C, blood pressure, lipid profile, and microalbuminuria constantly increased over the years. The percentage of individuals with A1C values 7.0% increased by 16.6%, while the proportion of patients with blood pressure 130/85 mmHg increased by 10.7%. The percentage of individuals with LDL cholesterol levels <100 mg/dl had a marked increase from 19.4 to 44.1%. Rates of use of lipid-lowering drugs, antihypertensive drugs, and aspirin also substantially raised over the years.

CONCLUSIONS—We found a strong consistency between increasing rates of monitoring, increasing drug prescription, and better levels of intermediate outcomes. Despite the satisfactory achievements, a substantial room for improvement in the care of diabetes still persists.

Abbreviations: ARB, angiotensin receptor blocker

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. C.E. Rossi, A. Nicolucci, A. Arcangeli, A. Cimino, G. De Bigontina, C. Giorda, I. Meloncelli, F. Pellegrini, U. Valentini, G. Vespasiani, et al. Baseline Quality-of-Care Data From a Quality-Improvement Program Implemented by a Network of Diabetes Outpatient Clinics Diabetes Care, November 1, 2008; 31(11): 2166 - 2168. [Abstract] [Full Text] [PDF]