Health-System-Based Interventions to Improve Care in Pediatric and Adolescent Type 1 Diabetes

作者：Corathers Sarah D; Schoettker Pamela J; Clements Mark A; List Betsy A; Mullen Deborah; Ohmer Amy; Shah Avni; Lee Joyce

来源：Current Diabetes Reports, 2015, 15(11): 91.

DOI：10.1007/s11892-015-0664-8

• Type 1 diabetes
• Quality improvement
• Chronic Care Model
• Learning Health Systems

Despite significant advances in pharmacology and technology, glycemic targets are difficult to achieve for patients with type 1 diabetes (T1D) and management remains burdensome for patients and their families. Quality improvement (QI) science offers a methodology to identify an aim, evaluate complex contributors to the goal, and test potential interventions to achieve outcomes of interest. Day-to-day management of diabetes is often an iterative process but interventions exist at all care levels: individual patient and family, clinic, and larger population and health system. This article reviews current literature and proposes novel QI interventions for enhancing health outcomes, with attention to essential determinants or drivers of improved glycemic control and patient experience for pediatric T1D in the context of the Chronic Care Model. In-depth consideration of key drivers of successful T1D care, including self-management and integration of technology, are explored, and examples of larger health systems with improved outcomes, including Learning Health Systems are highlighted.

• 出版日期2015-11