Self-management aspects of the improving chronic illness care breakthrough series: Implementation with diabetes and heart failure teams
Self-management aspects of the improving chronic illness care breakthrough series: Implementation with diabetes and heart failure teams
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DOI：
10.1207/s15324796abm2402_04
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发表时间：
2002-03-01
影响因子：
3.8
通讯作者：
Wagner, EH
中科院分区：
文献类型：
--
作者：
Glasgow, RE;Funnell, MM;Wagner, EH
自我管理是慢性病管理中必不可少但经常被忽视的组成部分，实施起来具有挑战性。有关自我管理干预措施的现有有效性数据往往来自独立项目，而不是来自将自我管理纳入常规医疗护理的努力。本文介绍了慢性病护理突破系列中将自我管理支持整合到更广泛的医疗保健系统变革中以提高患者护理质量的努力。我们描述了系统变革的一般方法（慢性护理模型）和所使用的更具体的自我管理培训模型。讨论了自我管理培训组织中使用的流程，并提供了来自 21 个医疗保健系统的团队的数据，这些团队参与了为期 13 个月的突破系列，以解决糖尿病和心力衰竭护理问题。可用的系统级数据表明团队来自。各种医疗保健组织在为自我管理提供的支持方面做出了改进。糖尿病和心力衰竭团队均发现了改进，这表明这种改进过程可能广泛适用。讨论了经验教训、成功的关键以及未来研究和实践的方向。
Self-management is an essential but frequently neglected component of chronic illness management that is challenging to implement. Available effectiveness data regarding self-management interventions tend to be from stand-alone programs rather than from efforts to integrate self-management into routine medical care. This article describes efforts to integrate self-management support into broader health care systems change to improve the quality of patient care in the Chronic Illness Care Breakthrough Series. We describe the general approach to system change (the Chronic Care Model) and the more specific self-management training model used. The process used in training organizations in self-management is discussed, and data are presented ore teams from 21 health care systems participating in a 13-month-long Breakthrough Series to address diabetes and heart failure care. Available system-level data suggest that teams from. a variety of health care organizations made improvements in support provided for self-management. Improvements were found for both diabetes and heart failure teams, suggesting that this improvement process may be broadly applicable. Lessons learned, keys to success, and directions for future research and practice are discussed.