The American Diabetes Association has found that despite having available standards of care in diabetes, implementing these standards in most clinical settings has been suboptimal. Consider the following alarming statistics:
- 37% of diagnosed diabetics have an A1C of <7%.
- 36% of diagnosed diabetics have a blood pressure of <130/80.
- 48% of diagnosed diabetics have a total cholesterol <200.
- Only 7.3% of diagnosed diabetics have all three parameters at target goal.
Despite numerous scientific advances in medicine, electronic technology, and point of care assessment tools, there are many causes for these poor statistics. The largest obstacles to optimal care are a fragmented health care delivery system that lacks clinical information capabilities, often duplicates services, and is not designed for delivering chronic health care. Interdisciplinary team approaches that collaborate with patients in self-empowerment and self-management education have been found to be better suited for patients with chronic care issues. The Institute of Medicine has recommended changes to delivery systems so that they provide care that is evidence based, patient centered, systems oriented, and includes information technology that fosters continuous quality improvement (CQI).
Several large health institutions such as Kaiser Permanente, the Veteran’s Administration, regional health networks, and smaller group practices have published many continuous quality improvement (CQI) projects that incorporated clinical practice outcome assessments, patient centered approaches, system design changes, and reassessment of their clinical outcomes after interventions.
Continuous Quality Improvement (CQI)
CQI is a concept that originated from the world of business and manufacturing. The underlying principle is that there is always room for improvement. Within companies, it is the commitment to constantly improve operations, processes and activities in order to meet customer requirements in an efficient, consistent and cost effective manner. The focus is not on individuals but on processes. CQI promotes the need for objective data to analyze and improve processes, and this approach is also applicable in health care settings. Effective CQI projects have been found to directly improve health outcomes. The American Diabetes Association considers ongoing CQI vital to delivering quality diabetes care.
|Continuous Quality Improvement|
|Core Concepts of CQI||
|Core Steps in Continuous Improvement||
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