C. Jason Wang MD, PhD (is Professor of Pediatrics and Health Policy, Stanford University School of Medicine, and Director, Center for Policy, Outcomes and Prevention, Stanford Medicine.), Eugene M. Lewit PhD (is Adjunct Lecturer, Department of Health Policy, Stanford University School of Medicine.), Catherine L. Clark PhD (formerly Clinical Research Manager and Data Analyst, Project ECHO Diabetes, Stanford Medicine, is Clinical Research Associate, Abbott, Santa Clara, California.), Fu-Shiuan Whitney Lee MD, MPH (formerly Research Assistant, Stanford University School of Medicine, is Resident Physician, Stanford Children's Health / Lucile Packard Children's Hospital Stanford.), David M. Maahs MD, PhD (is Professor and Division Chief, Pediatric Endocrinology, Stanford University School of Medicine, and Principal Investigator, Project ECHO Diabetes, Stanford Medicine.), Michael James Haller MD (is Professor and Chief, Pediatric Endocrinology, Department of Pediatrics, University of Florida College of Medicine.), Ananta Addala DO (is Assistant Professor of Pediatrics (Endocrinology), and Co-Clinic Director, Project ECHO Diabetes.), Rayhan A. Lal MD (is Assistant Professor of Medicine and of Pediatrics (Endocrinology), Stanford University School of Medicine, and Co-Clinic Director, Project ECHO Diabetes.), Nicolas Cuttriss MD, MPH (is Founding Director and CEO, ECHO Diabetes Action Netowrk.), Linda G. Baer MSPH, CHCP (is Co-Founder and COO, ECHO Diabetes Action Network.), Lauren E. Figg LMSW (is Clinic Coordinator, Project ECHO Diabetes. Claudia Añez-Zabala is _____________, Department of Pediatrics, University of Florida College of Medicine.), Claudia Añez-Zabala, Eleni P. Sheehan APRN (is Advanced Registered Nurse Practitioner, Department of Pediatrics, University of Florida College of Medicine.), Sarah C. Westen PhD (is Clinical Assistant Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions.), Angelina V. Bernier MD (is Associate Professor and Fellowship Director, Department of Pediatrics, University of Florida College of Medicine.), William Troy Donahoo MD, FTOS (is Chief and Clinical Professor, Division of Endocrinology, Diabetes & Metabolism, University of Florida College of Medicine.), Ashby Farmer Walker PhD (is Research Assistant Professor, Health Outcomes and Policy, University of Florida College of Public Health and Health Professions. Please address correspondence to C. Jason Wang)
{"title":"Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network","authors":"C. Jason Wang MD, PhD (is Professor of Pediatrics and Health Policy, Stanford University School of Medicine, and Director, Center for Policy, Outcomes and Prevention, Stanford Medicine.), Eugene M. Lewit PhD (is Adjunct Lecturer, Department of Health Policy, Stanford University School of Medicine.), Catherine L. Clark PhD (formerly Clinical Research Manager and Data Analyst, Project ECHO Diabetes, Stanford Medicine, is Clinical Research Associate, Abbott, Santa Clara, California.), Fu-Shiuan Whitney Lee MD, MPH (formerly Research Assistant, Stanford University School of Medicine, is Resident Physician, Stanford Children's Health / Lucile Packard Children's Hospital Stanford.), David M. Maahs MD, PhD (is Professor and Division Chief, Pediatric Endocrinology, Stanford University School of Medicine, and Principal Investigator, Project ECHO Diabetes, Stanford Medicine.), Michael James Haller MD (is Professor and Chief, Pediatric Endocrinology, Department of Pediatrics, University of Florida College of Medicine.), Ananta Addala DO (is Assistant Professor of Pediatrics (Endocrinology), and Co-Clinic Director, Project ECHO Diabetes.), Rayhan A. Lal MD (is Assistant Professor of Medicine and of Pediatrics (Endocrinology), Stanford University School of Medicine, and Co-Clinic Director, Project ECHO Diabetes.), Nicolas Cuttriss MD, MPH (is Founding Director and CEO, ECHO Diabetes Action Netowrk.), Linda G. Baer MSPH, CHCP (is Co-Founder and COO, ECHO Diabetes Action Network.), Lauren E. Figg LMSW (is Clinic Coordinator, Project ECHO Diabetes. Claudia Añez-Zabala is _____________, Department of Pediatrics, University of Florida College of Medicine.), Claudia Añez-Zabala, Eleni P. Sheehan APRN (is Advanced Registered Nurse Practitioner, Department of Pediatrics, University of Florida College of Medicine.), Sarah C. Westen PhD (is Clinical Assistant Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions.), Angelina V. Bernier MD (is Associate Professor and Fellowship Director, Department of Pediatrics, University of Florida College of Medicine.), William Troy Donahoo MD, FTOS (is Chief and Clinical Professor, Division of Endocrinology, Diabetes & Metabolism, University of Florida College of Medicine.), Ashby Farmer Walker PhD (is Research Assistant Professor, Health Outcomes and Policy, University of Florida College of Public Health and Health Professions. Please address correspondence to C. Jason Wang)","doi":"10.1016/j.jcjq.2023.08.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The telementoring Project ECHO (Extension for Community Healthcare Outcomes) model has been shown to improve disease management in diabetes in many underserved communities. The authors aim to evaluate if ECHO could also be an effective tool for quality improvement (QI) of diabetes care in these communities.</p></div><div><h3>Methods</h3><p>Thirteen clinics in underserved communities in California and Florida participating in Project ECHO Diabetes were recruited for a 12-month QI program. The program provided weekly tele-education sessions, including a didactic presentation and case-based discussion. In addition, clinics chose their own set of quality measures to improve and met remotely to discuss their efforts, successes, and setbacks every quarter with mentorship from QI experts.</p></div><div><h3>Results</h3><p>Of the 31 QI initiatives attempted by different clinics, all had either made improvements (25 initiatives, 80.6%) or were in the process of making improvements (6 initiatives, 19.4%) in structural, process, and outcome measures. Examples of these measures include whether clinics have protocols to identify high-risk patients (structure), numbers of continuous glucose monitor prescriptions submitted by the clinics (process), and percentage of patients with diabetes whose most recent HbA1c are > 9% (outcome). For one measure, 40.0% of the clinics had achieved a higher percentage of cumulative HbA1c measurement in the third quarter of the year, compared to the fourth quarter in the previous year. The cost of QI implementation varied widely due to different number of personnel involved across sites.</p></div><div><h3>Conclusion</h3><p>A QI program delivered via Project ECHO Diabetes can facilitate quality improvements in underserved communities.</p></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1553725023001915/pdfft?md5=5c22961e3996d30f51e577424eec80d7&pid=1-s2.0-S1553725023001915-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725023001915","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The telementoring Project ECHO (Extension for Community Healthcare Outcomes) model has been shown to improve disease management in diabetes in many underserved communities. The authors aim to evaluate if ECHO could also be an effective tool for quality improvement (QI) of diabetes care in these communities.
Methods
Thirteen clinics in underserved communities in California and Florida participating in Project ECHO Diabetes were recruited for a 12-month QI program. The program provided weekly tele-education sessions, including a didactic presentation and case-based discussion. In addition, clinics chose their own set of quality measures to improve and met remotely to discuss their efforts, successes, and setbacks every quarter with mentorship from QI experts.
Results
Of the 31 QI initiatives attempted by different clinics, all had either made improvements (25 initiatives, 80.6%) or were in the process of making improvements (6 initiatives, 19.4%) in structural, process, and outcome measures. Examples of these measures include whether clinics have protocols to identify high-risk patients (structure), numbers of continuous glucose monitor prescriptions submitted by the clinics (process), and percentage of patients with diabetes whose most recent HbA1c are > 9% (outcome). For one measure, 40.0% of the clinics had achieved a higher percentage of cumulative HbA1c measurement in the third quarter of the year, compared to the fourth quarter in the previous year. The cost of QI implementation varied widely due to different number of personnel involved across sites.
Conclusion
A QI program delivered via Project ECHO Diabetes can facilitate quality improvements in underserved communities.
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