The feasibility of implementing the chronic care model in the management of diabetes at a public health center in Lebanon -

Abstract

In a Lebanese primary healthcare center, a gap analysis was conducted to assess the feasibility of implementing the Chronic Care Model in the management of diabetes.The Assessment of Chronic Illness Care (ACIC tool version 3.5) was used to assess the implementation of the Chronic Care Model elements in the healthcare center. One multi-disciplinary team consisting of two nurses, one physician, one social worker and the nursing director (as the team leader) were asked to complete the ACIC tool. Every member was asked to score the criteria for one element within a one week time frame. A “respond and think aloud” method was used to elaborate on the results among the multi-disciplinary team members.Average component score of diabetes management at the center was 6.18 reflecting good support for diabetes care. The delivery system designed scored the highest (average score= 8.8), followed by the decision support (average score= 7.2), then by self-management (average score=6.5), clinical information system (average score=5.6), the organization of healthcare system (average score=5.5), integration element (average score=5.1) and community linkage (average score=4.6). The healthcare center has some gaps related to every element in the chronic care model. A quality improvement plan was designed with goals and objectives to fill the gaps. For example, evidence based integration in practice, utilization of comprehensive quality improvement plans, offering incentives for nurses to get certifications, contracts with other community resources, and utilization of clinical information registries can be implemented to improve the management of diabetes care at the center.Implementing the Chronic Care Model for the management of diabetes is feasible in order to enhance better patient outcomes, and assist in management and prevention of diabetes and other chronic diseases.