Journal of Community Health

, Volume 36, Issue 2, pp 180–190 | Cite as

An Asthma and Diabetes Quality Improvement Project: Enhancing Care in Clinics and Community Health Centers

  • Alan Silver
  • James Figge
  • Donna L. Haskin
  • Veronica Pryor
  • Karen Fuller
  • Thomas Lemme
  • Nancy Li
  • Mary Jane O’Brien
Original paper


Asthma and diabetes are major chronic conditions in the United States, particularly in the Medicaid population. The majority of care for these diseases occurs at ambulatory practice sites. The New York State Department of Health Office of Health Insurance Programs (OHIP) worked with IPRO, the New York State Medicare quality improvement organization, to develop and implement a quality improvement project (QIP) for these conditions. The approach was based upon the Chronic Care Model and used an iterative academic-detailing methodology. Clinics and community health centers volunteered to participate and used IPRO-collected data with audit and feedback to improve their practices. Several metrics significantly improved for asthma (e.g., use of anti-inflammatory long term controller agents, assessment of asthma severity, use of asthma action plans) and for diabetes (e.g., lipid testing and control, A1c testing). Key organizational elements of success included senior medical leadership commitment and practice site quality improvement team meetings. OHIP has used the QIP experience to begin patient-centered medical home implementation in New York State.


Asthma Diabetes Quality improvement Ambulatory care 



The authors wish to thank Dr. Foster Gesten, Medical Director, Office of Health Insurance Programs for his review of the manuscript; Ms. Katja Ocepek-Welikson and Mr. Ti-Kuang Lee of IPRO for their assistance in the data analysis.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Alan Silver
    • 1
  • James Figge
    • 2
  • Donna L. Haskin
    • 2
  • Veronica Pryor
    • 1
  • Karen Fuller
    • 2
  • Thomas Lemme
    • 1
  • Nancy Li
    • 1
  • Mary Jane O’Brien
    • 2
  1. 1.IPRO Health Care Quality Improvement TeamLake SuccessUSA
  2. 2.New York State Department of Health Office of Health Insurance Programs TeamAlbanyUSA

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