Joy and Challenges in Improving Chronic Illness Care

“Lots happening today… Absolutely awesome interdisciplinary team meeting with residents presenting complex patients…residents discussed a team approach to patient care…” -Physician

This report presents a qualitative evaluation of the Academic Chronic Care Collaboratives (ACCCs), with an emphasis on implementing the Chronic Care Model (CCM) in academic settings. The authors developed an electronic team survey (ETS) to find out what important daily events influenced team members’ work. Study participants received regular e-mails asking them to, “Briefly describe ONE event that stands out in your mind from today’s work.” The authors of this evaluation used qualitative analysis software to assign responses to themes and categories.

For teams focused on improving diabetes, the authors linked the ETS responses to quantitative data on clinical outcomes (submitted in monthly reports during the ACCCs). Using an assessment scale, the authors ranked team performance. The authors compared high-performing and low-performing teams to determine if any of the qualitative themes, captured by the ETS, were factors in team performance.

Key Findings:

  • The six most common themes from the ETS were: 1) mindfulness of patient care; 2) changes in work attributed to ACCC experience; 3) greater focus on patient education; 4) multidisciplinary team function; 5) mindfulness of learner interactions; 6) reflection on action.
  • Professional satisfaction (i.e., finding joy in their work), contributed to high performance among ACCC teams.

The ACCCs were made possible by a partnership between the Institute for Improving Clinical Care of the Association of American Medical Colleges (AAMC) and Improving Chronic Illness Care, a national program based at Group Health Cooperative. The Robert Wood Johnson Foundation provided funding and organizational support.