Assessing Chronic Illness Care Education (ACIC-E): A Tool for Tracking Educational Re-design for Improving Chronic Care Education
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Recent Breakthrough Series Collaboratives have focused on improving chronic illness care, but few have included academic practices, and none have specifically targeted residency education in parallel with improving clinical care. Tools are available for assessing progress with clinical improvements, but no similar instruments have been developed for monitoring educational improvements for chronic care education.
To design a survey to assist teaching practices with identifying curricular gaps in chronic care education and monitor efforts to address those gaps.
During a national academic chronic care collaborative, we used an iterative method to develop and pilot test a survey instrument modeled after the Assessing Chronic Illness Care (ACIC). We implemented this instrument, the ACIC-Education, in a second collaborative and assessed the relationship of survey results with reported educational measures.
A combined 57 self-selected teams from 37 teaching hospitals enrolled in one of two collaboratives.
We used descriptive statistics to report mean ACIC-E scores and educational measurement results, and Pearson’s test for correlation between the final ACIC-E score and reported educational measures.
A total of 29 teams from the national collaborative and 15 teams from the second collaborative in California completed the final ACIC-E. The instrument measured progress on all sub-scales of the Chronic Care Model. Fourteen California teams (70%) reported using two to six education measures (mean 4.3). The relationship between the final survey results and the number of educational measures reported was weak (R2 = 0.06, p = 0.376), but improved when a single outlier was removed (R2 = 0.37, p = 0.022).
The ACIC-E instrument proved feasible to complete. Participating teams, on average, recorded modest improvement in all areas measured by the instrument over the duration of the collaboratives. The relationship between the final ACIC-E score and the number of educational measures was weak. Further research on its utility and validity is required.
- Crossing the Quality Chasm: a New Health System for the Twenty-first Century. National Academy Press, Washington
- Stevens, DP, Wagner, EH (2006) Transforming residency training in chronic illness care—now. Acad Med 81: pp. 685-687 CrossRef
- Jackson, GL, Weinberger, M (2009) A decade with the chronic care model: some progress and opportunity for more. Med Care 47: pp. 929-931 CrossRef
- Bodenheimer, T, Chen, E, Bennett, H (2009) Confronting the growing burden of chronic disease: can the US health care workforce do the job?. Health Aff 28: pp. 64-74 CrossRef
- Foote, SM (2009) Next steps: how can Medicare accelerate the pace of improving chronic care?. Health Aff 28: pp. 99-102 CrossRef
- Chin, MH, Drum, ML, Guillen, M (2007) Improving and sustaining diabetes care in community health centers with the disparities collaboratives. Med Care 45: pp. 1135-1143 CrossRef
- Wagner, EH, Austin, BT, Korff, M (1996) Organizing care for patients with chronic illness. Milbank Q 74: pp. 511-544 CrossRef
- Landis, SE, Schwarz, M, Curran, DR (2006) North Carolina family medicine residency programs’ diabetes learning collaborative. Fam Med 38: pp. 190-195
- Warm, EJ, Schauer, DP, Diers, T (2008) The ambulatory long-block: an Accreditation Council for Graduate Medical Education (ACGME) Educational Innovations Project (EIP). J Gen Intern Med 23: pp. 921-926 CrossRef
- Dipiero, A, Dorr, DA, Kelso, C, Bowen, JL (2008) Integrating systematic chronic care for diabetes into an academic general internal medicine resident-faculty practice. JGIM 23: pp. 1749-1756 CrossRef
- Wagner, EH, Austin, BT, Davis, C, Hindmarsh, M, Schaefer, J, Bonomi, A (2001) Improving chronic illness care: translating evidence into action. Health Aff 20: pp. 64-78 CrossRef
- Institute for Healthcare Improvement. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. 2003.
- Coleman, K, Austin, BT, Brach, C, Wagner, WH (2009) Evidence on the chronic care model in the new millennium. Health Aff 28: pp. 75-85 CrossRef
- Bonomi, AE, Wagner, EH, Glasgow, RE, VonKorff, M (2002) Assesment of Chronic Illness Care (ACIC): a practical tool to measure quality improvement. Health Serv Res 37: pp. 791-820 CrossRef
- http://improvingchroniccare.org/index.php?p=Survey_Instruments&s=165 (ACIC 3.5, accessed March 23, 2010)
- Bowen JL, Stevens DP, Sixta CS, et al. Developing measures of educational change for collaborative teams implementing the Chronic Care Model in teaching practices. JGIM 2010; doi:10.1007/s11606-010-1358-1
- Assessing Chronic Illness Care Education (ACIC-E): A Tool for Tracking Educational Re-design for Improving Chronic Care Education
Journal of General Internal Medicine
Volume 25, Issue 4 Supplement, pp 593-609
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- chronic care
- ambulatory care
- graduate medical education
- quality improvement
- Industry Sectors
- Author Affiliations
- 1. Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239-3098, USA
- 2. Associates in Process Improvement, Austin, TX, USA
- 3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
- 4. Faculty of Medicine, University of New South Wales, Kensington, Australia
- 5. Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
- 6. UTHSC School of Nursing, Houston, TX, USA
- 7. MacColl Institute for Healthcare Innovation, Group Health Center for Health Studies, Seattle, WA, USA