RT Journal Article
SR Electronic
T1 Identifying strategies to improve diabetes care in Alberta, Canada, using the knowledge-to-action cycle
JF CMAJ Open
FD Canadian Medical Association
SP E142
OP E150
DO 10.9778/cmajo.20130024
VO 1
IS 4
A1 Manns, Braden
A1 Braun, Ted
A1 Edwards, Alun
A1 Grimshaw, Jeremy
A1 Hemmelgarn, Brenda
A1 Husereau, Don
A1 Ivers, Noah
A1 Johnson, Jeff
A1 Long, Steve
A1 McBrien, Kerry
A1 Naugler, Christopher
A1 Sargious, Peter
A1 Straus, Sharon
A1 Tonelli, Marcello
A1 Tricco, Andrea C.
A1 Yu, Catherine
A1 ,
A1 ,
YR 2013
UL http://www.cmajopen.ca/content/1/4/E142.abstract
AB Background Strategic clinical networks, a recent development in the health system in Alberta, have been charged with bringing together front-line clinicians, researchers and policy-makers to identify variation in clinical care, and to propose standards, pathways and innovative solutions to improve access and quality of care. Here, we describe a collaborative workshop held between researchers and the Obesity, Diabetes and Nutrition Strategic Clinical Network to describe barriers to and facilitators of care for people with diabetes and to identify quality improvement interventions that should be prioritized. Methods Through collaboration between health researchers and the strategic clinical network, and using principles of the knowledge-to-action cycle, we identified barriers to and facilitators of diabetes care using data from a patient survey and a provider focus group (5 primary care physicians and 1 diabetes educator). In addition, we identified best evidence from a systematic review of quality improvement initiatives in diabetes. This information was reviewed at a multistakeholder workshop where potential quality improvement initiatives were considered at various service levels. Results A pilot survey involving 59 patients with diabetes and a focus group of primary care and allied health care providers identified several important barriers to optimal outcomes in diabetes care, including patient-level financial barriers to care and difficulty navigating the health system. Our collaborative discussion using the knowledge-to-action cycle prioritized feasible, evidence-based interventions to improve outcomes for patients with diabetes, including enabling care by allied health care providers and creating clear care maps and processes for system navigation. Interpretation We identified important barriers to achieving optimal outcomes in diabetes that may be overcome through the use of evidence-based quality improvement interventions. As recommended within the knowledge-to-action cycle, future research is required to determine whether program implementation improves outcomes and is cost-effective.