Performance Measures

June 2006 Volume 32 Number 6 More than 97% of adults with diabetes seek their care from family physicians, general internists, or general practitioners, accounting for 76% of all outpatient visits provided to adults with diabetes. Translating theoretically sound strategies that work in research settings into real-world primary care practices has been a challenge. The Chronic Illness Care model suggests that there are six structural dimensions of primary care teams that are important to improve the care delivered to patients with a complex chronic illness such as Type 2 diabetes— organizational support, community linkages, decisions support, self-management support, delivery system design, and clinical information systems. The goal of implementing the model is to make care proactive and patient centered rather than episodic and acute care based. Implementing the elements of the Chronic Illness Care model has been shown to improve processes of care for several chronic illnesses, including diabetes. Evaluation of the implementation of the Chronic Illness Care model has been assessed using the Assessment of Chronic Illness Care (ACIC) survey. The ACIC survey consists of 25 questions that constitute the model’s six structural dimensions. In a study of organizational characteristics associated with chronic illness care, all six ACIC subscales were responsive to practice improvements made for diabetes and congestive heart failure care. However, this evaluation instrument is typically completed by members of a team of personnel from each clinic who are involved in quality improvement initiatives. Little is known about how staff roles may influence their rating of the Chronic Illness Care Assessing Chronic Illness Care for Diabetes in Primary Care Clinics Performance Measures