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Research ArticleSpecial Communication

Crossing the Quality Chasm for Diabetes Care: The Power of One Physician, His Team, and Systems Thinking

Leif I. Solberg, David H. Klevan and Stephen E. Asche
The Journal of the American Board of Family Medicine May 2007, 20 (3) 299-306; DOI: https://doi.org/10.3122/jabfm.2007.03.060132
Leif I. Solberg
MD
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David H. Klevan
MD
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Stephen E. Asche
MA
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Article Figures & Data

Tables

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    Table 1.

    Characteristics of DHK's Patient Cohort as of March 2006 (N = 43)

    CharacteristicnPercentage
    Age (years)
        32–46512
        46–652763
        65–751126
    Male2865
    Race/ethnicity
        White3377
        Black37
        Hispanic37
        Asian37
        Arabic12
    Type II diabetes3479
    Comorbidities requiring hospitalization
        Coronary disease921
        Stroke49
        Foot ulcer25
        Heart failure25
    Diabetes medications
        Insulin2046
        Metformin2149
        Sulfonylurea1740
        Glitizone1535
        None12
    Antihypertensive medications
        01023
        1819
        21432
        >21126
    Other medications
        Statin3274
        Ezetimibe716
        Other lipid types25
        No lipid meds921
        ACE/ARB2865
    • View popup
    Tabel 2.

    Percentage of Patients Achieving All ODC Goals Per Quarter (n = 7000 for medical group, varying for DHK)

    Patient Group20042005
    Q1Q2Q3Q4Q1Q2Q3Q4
    n7063696756556270
    DHK5.711.18.713.426.825.533.942.9
    Medical group4.25.87.48.610.711.212.012.1
    P.53.07.68.16.0001.0009<.0001<.0001
    • View popup
    Table 3.

    Percentage of DHK's Patients Achieving Each Component of ODC Goals (n = 70 in both quarters)

    QuarterLDL <100A1c <7BP <130Daily ASATobacco Free
    1 in 20044653715956
    4 in 20057550839691
    P.00080.720.11<.0001<.0001
    • ODC, optimal diabetes control; LDL, low-density lipoproteins; BP, blood pressure.

    • View popup
    Table 4.

    Percentage of DHK's Patients Who Were Present Throughout the Study, Who Achieved ODC Goals (n = 43)

    QuarterLDL <100A1c <7BP <130Daily ASATobacco FreeAll 5
    1 in 200442466556562
    4 in 20057954841009146
    P.0006.37.045<.0001.0001<.0001
    • ODC, optimal diabetes control; LDL, low-density lipoproteins; BP, blood pressure.

    • View popup
    Table 5.

    Mean Values* for DHK's Patients Who Were Lost or Added to His Care (at the time of departure or arrival)

    GroupnLDLA1cBPAge
    Lost2798 (2)†6.8 (4)12062 years
    Added2791 (3)7.711859 years
    P.46.053.75.25
    • * ASA and tobacco not included because status not well documented in 2004 for some of these patients.

    • † Numbers in parentheses are for the number of patients with no measure available.

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The Journal of the American Board of Family Medicine: 20 (3)
The Journal of the American Board of Family Medicine
Vol. 20, Issue 3
May-June 2007
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Crossing the Quality Chasm for Diabetes Care: The Power of One Physician, His Team, and Systems Thinking
Leif I. Solberg, David H. Klevan, Stephen E. Asche
The Journal of the American Board of Family Medicine May 2007, 20 (3) 299-306; DOI: 10.3122/jabfm.2007.03.060132

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Crossing the Quality Chasm for Diabetes Care: The Power of One Physician, His Team, and Systems Thinking
Leif I. Solberg, David H. Klevan, Stephen E. Asche
The Journal of the American Board of Family Medicine May 2007, 20 (3) 299-306; DOI: 10.3122/jabfm.2007.03.060132
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