The National and California Academic Chronic Care Collaboratives (ACCCs) used teamwork to overcome the chaotic, overcrowded environment of primary care. The ACCCs helped primary care residents discover new meaning in their work.

Many residents steer clear of primary care because of its overwhelming workload and disorganization. Health care teams can overcome these difficulties. Residents find their work more rewarding when they work within a team.

The introduction to this supplement of the Journal of General Internal Medicine, Chronic Care Education, describes the achievements of the ACCCs and the Chronic Care Model (CCM)–a framework for training residents in chronic illness care. The ACCCs introduced CCM to teaching hospitals in California and throughout the U.S. Key Findings:

• The ACCCs created highly organized primary care teams, doing away with archaic, counterproductive modes of authority.
• Patient registries gave residents a new, and in some cases eye-opening, perspective on the quality of care residents were providing.
• The Chronic Care Collaboratives empowered patients to make the daily decisions required to live with diabetes.

The ACCCs created successful primary care teams. As team members began to see improvement in the results of chronic care, skepticism gave way to optimism. Primary care residents, who in the past were isolated authority figures, participated as team members. Residents in training came from pediatrics, internal medicine and family medicine.

The Chronic Care Model was developed as the result of Improving Chronic Care, a national program funded by the Robert Wood Johnson Foundation between May 1998 and December 2009.