PT - JOURNAL ARTICLE AU - Halladay, Jacqueline R. AU - DeWalt, Darren A. AU - Wise, Alison AU - Qaqish, Bahjat AU - Reiter, Kristin AU - Lee, Shoou-Yih AU - Lefebvre, Ann AU - Ward, Kimberly AU - Mitchell, C. Madeline AU - Donahue, Katrina E. TI - More Extensive Implementation of the Chronic Care Model is Associated with Better Lipid Control in Diabetes AID - 10.3122/jabfm.2014.01.130070 DP - 2014 Jan 01 TA - The Journal of the American Board of Family Medicine PG - 34--41 VI - 27 IP - 1 4099 - http://www.jabfm.org/content/27/1/34.short 4100 - http://www.jabfm.org/content/27/1/34.full SO - J Am Board Fam Med2014 Jan 01; 27 AB - Objective: Chronic disease collaboratives help practices redesign care delivery. The North Carolina Improving Performance in Practice program provides coaches to guide implementation of 4 key practice changes: registries, planned care templates, protocols, and self-management support. Coaches rate progress using the Key Drivers Implementation Scales (KDIS). This study examines whether higher KDIS scores are associated with improved diabetes outcomes. Methods: We analyzed clinical and KDIS data from 42 practices. We modeled whether higher implementation scores at year 1 of participation were associated with improved diabetes measures during year 2. Improvement was defined as an increase in the proportion of patients with hemoglobin A1C values <9%, blood pressure values <130/80 mmHg, and low-density lipoprotein (LDL) levels <100 mg/dL. Results: Statistically significant improvements in the proportion of patients who met the LDL threshold were noted with higher “registry” and “protocol” KDIS scores. For hemoglobin A1C and blood pressure values, none of the odds ratios were statistically significant. Conclusions: Practices that implement key changes may achieve improved patient outcomes in LDL control among their patients with diabetes. Our data confirm the importance of registry implementation and protocol use as key elements of improving patient care. The KDIS tool is a pragmatic option for measuring practice changes that are rooted in the Chronic Care Model.