alberta’s caring for diabetes (abcd) project a chronic disease management initiative jeffrey...
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Alberta’s Caring for Diabetes Alberta’s Caring for Diabetes (ABCD) Project(ABCD) Project
A Chronic Disease A Chronic Disease Management InitiativeManagement Initiative
Jeffrey Johnson, PhDJeffrey Johnson, PhDCanada Research Chair in Diabetes Health Outcomes Canada Research Chair in Diabetes Health Outcomes
Professor, Public Health SciencesProfessor, Public Health SciencesUniversity of AlbertaUniversity of Alberta
Alberta’s Diabetes Strategy Alberta’s Diabetes Strategy 2003-20132003-2013
Primary Prevention(HAC)
2o & 3o Prevention
AMFH – Supplies
Screening FN Off-Reserve (MDSI)
ABCD Project
May 2003
October 2003
Alberta’s Caring for Diabetes Alberta’s Caring for Diabetes (ABCD) Project(ABCD) Project
CDM Intervention
- patient enrollment
- annual follow-up
ADSS
AlbertaDM Atlas
2007
2009
2011
RegionalLabs
Lab Linkage
-region profiles
-MD profiles
ABCD ProjectABCD Project
AHW & IHE/ACHORD partnership $5.2 million from AHW; 2008-2013
Collaborative CDM initiatives Working with RHA/PCN Contribution of funding to support
collaborative CDM initiatives
Aim: to improve quality and efficiency of diabetes care in Alberta
Key Data Linkages…
ADSS administrative data Regional Lab data
Lipids A1C ACR
PCN/clinic charts (EMR/paper charts) Patient-reported data (self-report survey)
ABCD Cohort (n=5,000) – 1/3 of non-metro pop’n
Alberta’s Caring for Diabetes Alberta’s Caring for Diabetes (ABCD) Project(ABCD) Project
ADSS Active DisseminationADSS Active Dissemination
Northern Lights Region (Wood Buffalo/Fort McMurray) April
Peace Country TBA Aspen (Westlock ) June East Central TBA DTHR (Red Deer) March Lethbridge (Chinook) Aug 07 Palliser Jan, Feb, April 25 Capital Ongoing Calgary Ongoing
Key Features… Evidence Based QI Intervention
DOVE Study to Rural health regions CDA-CPG dissemination/implementation
Enhanced surveillance Capitalizing on the ADSS Integrating data sources
- Administrative, Laboratory, Clinical, PRO Performance measurement & benchmarking
Integration with RHA/PCN planning Developing PCN practices Concurrent ‘disease management’ programs
Enhanced QI Intervention/Evaluation Controlled comparisons of new interventions Collaborative development of interventions
ABCD and RHA/PCNs…ABCD and RHA/PCNs…
ABCD
Baseline QISD Measurement
1-year QISD Measurement
2-year QISD Measurement
StandardCDA - CPG
Dissemination
DOVEIntervention
DOVEIntervention
+A&F
N= 2 RHAsn=1660
N= 2 RHAsn=1660
N= 2 RHAsn=1660
X
X
X
X
X
X
X
X\X\X\X\X
Enhanced QI Intervention & Evaluation …Enhanced QI Intervention & Evaluation …
Incidence of MI/Stroke
TreatmentQuality Improvement
Intervention
Control No Intervention
… a province-wide health services research laboratory!
DOVE DOVE Diabetes Outreach Van EnhancementStudy
Enhanced QI Intervention & Evaluation …Enhanced QI Intervention & Evaluation …
Jan – June 2008 ADSS Dissemination (RHA/PCN)
March 2008 funding received @ IHE
August 2008 Initial staffing
Sept - Dec 2008 RHA Laboratory Surveillance
QISD development
Staffing
Spring 2009 Implementation (lab surveillance)
- academic detailing
- audit & feedback
(ADSS Atlas 2009)
Annually to 2012
ABCD - time line…ABCD - time line…
AH&W
ACHORD/IHE
ABCD Project
Regional Integration Groups
ABCDManagement Teama
CE&E Steering Committeeb
aABCD Management Team would be based at ACHORD offices at the Alberta Diabetes Institute, University of Alberta in Edmonton. bClinical Evidence and Evaluation Steering Committee will be responsible for the overall implementation and evaluation of the ABCD Project
ABCD - Org Chart …ABCD - Org Chart …
Coordination of programs PCN initiated programs DNPC Stroke Prevention Strategy MDSI Quality indicators…which set…? Many more, ….
RHAs versus PCNs…?
Professional autonomy…? Big city specialists…. Involving AMA/TOPP…?
Regional buy-in … Local resources Integration outside “health care”
Sustainability…
ABCD - challenges …ABCD - challenges …
