Abstract
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 on 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 suc cess, and directions for future research and practice are discussed.
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This article was supported under Grant 0347984 to Group Health Cooperative from the Robert Wood Johnson Foundation and in part by the National Institute of Diabetes and Digestive and Kidney Diseases Grant NIH5P60-DK20572. Appreciation is expressed to other faculty involved in this Collaborative not mentioned in the text: Penny Carver, Jeremy Gleason, Steve Hagedorn, Jane Kelly, Lloyd Provost, Susan Woodley Restaino, and Connie Sixta, as well as to the participating health care teams for all their hard work and collegiality.
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Glasgow, R.E., Funnell, M.M., Bonomi, A.E. et al. Self-Management aspects of the improving chronic illness care breakthrough series: Implementation with diabetes and heart failure teams. ann. behav. med. 24, 80–87 (2002). https://doi.org/10.1207/S15324796ABM2402_04
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DOI: https://doi.org/10.1207/S15324796ABM2402_04