Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement
Objective. To describe initial testing of the Assessment of Chronic Illness Care (ACIC), a practical quality‐improvement tool to help organizations evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas: community linkages, self‐management support, decision...
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| Veröffentlicht in: | Health services research 2002-06, Vol.37 (3), p.791-820 |
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| creator | Bonomi, Amy E. Wagner, Edward H. Glasgow, Russell E. VonKorff, Michael |
| description | Objective. To describe initial testing of the Assessment of Chronic Illness Care (ACIC), a practical quality‐improvement tool to help organizations evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas: community linkages, self‐management support, decision support, delivery system design, information systems, and organization of care.
Data Sources. (1) Pre‐post, self‐report ACIC data from organizational teams enrolled in 13‐month quality‐improvement collaboratives focused on care for chronic illness; (2) independent faculty ratings of team progress at the end of collaborative.
Study design. Teams completed the ACIC at the beginning and end of the collaborative using a consensus format that produced average ratings of their system's approach to delivering care for the targeted chronic condition. Average ACIC subscale scores (ranging from 0 to 11, with 11 representing optimal care) for teams across all four collaboratives were obtained to indicate how teams rated their care for chronic illness before beginning improvement work. Paired t‐tests were used to evaluate the sensitivity of the ACIC to detect system improvements for teams in two (of four) collaboratives focused on care for diabetes and congestive heart failure (CHF). Pearson correlations between the ACIC subscale scores and a faculty rating of team performance were also obtained.
Results. Average baseline scores across all teams enrolled at the beginning of the collaboratives ranged from 4.36 (information systems) to 6.42 (organization of care), indicating basic to good care for chronic illness. All six ACIC subscale scores were responsive to system improvements diabetes and CHF teams made over the course of the collaboratives. The most substantial improvements were seen in decision support, delivery system design, and information systems. CHF teams had particularly high scores in self‐management support at the completion of the collaborative. Pearson correlations between the ACIC subscales and the faculty rating ranged from .28 to .52.
Conclusion. These results and feedback from teams suggest that the ACIC is responsive to health care quality‐improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time. |
| doi_str_mv | 10.1111/1475-6773.00049 |
| format | Article |
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Data Sources. (1) Pre‐post, self‐report ACIC data from organizational teams enrolled in 13‐month quality‐improvement collaboratives focused on care for chronic illness; (2) independent faculty ratings of team progress at the end of collaborative.
Study design. Teams completed the ACIC at the beginning and end of the collaborative using a consensus format that produced average ratings of their system's approach to delivering care for the targeted chronic condition. Average ACIC subscale scores (ranging from 0 to 11, with 11 representing optimal care) for teams across all four collaboratives were obtained to indicate how teams rated their care for chronic illness before beginning improvement work. Paired t‐tests were used to evaluate the sensitivity of the ACIC to detect system improvements for teams in two (of four) collaboratives focused on care for diabetes and congestive heart failure (CHF). Pearson correlations between the ACIC subscale scores and a faculty rating of team performance were also obtained.
Results. Average baseline scores across all teams enrolled at the beginning of the collaboratives ranged from 4.36 (information systems) to 6.42 (organization of care), indicating basic to good care for chronic illness. All six ACIC subscale scores were responsive to system improvements diabetes and CHF teams made over the course of the collaboratives. The most substantial improvements were seen in decision support, delivery system design, and information systems. CHF teams had particularly high scores in self‐management support at the completion of the collaborative. Pearson correlations between the ACIC subscales and the faculty rating ranged from .28 to .52.
Conclusion. These results and feedback from teams suggest that the ACIC is responsive to health care quality‐improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time.</description><identifier>ISSN: 0017-9124</identifier><identifier>EISSN: 1475-6773</identifier><identifier>DOI: 10.1111/1475-6773.00049</identifier><identifier>PMID: 12132606</identifier><identifier>CODEN: HESEA5</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science, Ltd</publisher><subject>Chronic Disease - therapy ; chronic illness ; Chronic illnesses ; Chronically ill ; health care ; Health care delivery ; Health care industry ; Health insurance ; Health insurance industry ; Hospitals ; Humans ; Management ; Measurement ; Medical care ; Medical treatment ; Methods ; Outcome and Process Assessment (Health Care) ; Patient Care Team ; Patient-Centered Care ; Program Evaluation ; quality ; Quality of Health Care - standards ; Quality of service ; Statistical analysis ; Studies ; systems ; Time Factors ; Total Quality Management - methods ; Total Quality Management - organization & administration ; United States</subject><ispartof>Health services research, 2002-06, Vol.37 (3), p.791-820</ispartof><rights>COPYRIGHT 2002 Health Research and Educational Trust</rights><rights>COPYRIGHT 2002 Health Research and Educational Trust</rights><rights>Copyright Hospital Research and Educational Trust Jun 2002</rights><rights>2002 Health Research and Education Trust 2002</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c7059-6afc27f6c77458e54a097b852805acd72268f9ece4cf7b220076067d33da8d643</citedby><cites>FETCH-LOGICAL-c7059-6afc27f6c77458e54a097b852805acd72268f9ece4cf7b220076067d33da8d643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1434662/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1434662/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27923,27924,30998,45574,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12132606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bonomi, Amy E.</creatorcontrib><creatorcontrib>Wagner, Edward H.</creatorcontrib><creatorcontrib>Glasgow, Russell E.</creatorcontrib><creatorcontrib>VonKorff, Michael</creatorcontrib><title>Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement</title><title>Health services research</title><addtitle>Health Serv Res</addtitle><description>Objective. To describe initial testing of the Assessment of Chronic Illness Care (ACIC), a practical quality‐improvement tool to help organizations evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas: community linkages, self‐management support, decision support, delivery system design, information systems, and organization of care.
Data Sources. (1) Pre‐post, self‐report ACIC data from organizational teams enrolled in 13‐month quality‐improvement collaboratives focused on care for chronic illness; (2) independent faculty ratings of team progress at the end of collaborative.
Study design. Teams completed the ACIC at the beginning and end of the collaborative using a consensus format that produced average ratings of their system's approach to delivering care for the targeted chronic condition. Average ACIC subscale scores (ranging from 0 to 11, with 11 representing optimal care) for teams across all four collaboratives were obtained to indicate how teams rated their care for chronic illness before beginning improvement work. Paired t‐tests were used to evaluate the sensitivity of the ACIC to detect system improvements for teams in two (of four) collaboratives focused on care for diabetes and congestive heart failure (CHF). Pearson correlations between the ACIC subscale scores and a faculty rating of team performance were also obtained.
Results. Average baseline scores across all teams enrolled at the beginning of the collaboratives ranged from 4.36 (information systems) to 6.42 (organization of care), indicating basic to good care for chronic illness. All six ACIC subscale scores were responsive to system improvements diabetes and CHF teams made over the course of the collaboratives. The most substantial improvements were seen in decision support, delivery system design, and information systems. CHF teams had particularly high scores in self‐management support at the completion of the collaborative. Pearson correlations between the ACIC subscales and the faculty rating ranged from .28 to .52.
Conclusion. These results and feedback from teams suggest that the ACIC is responsive to health care quality‐improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time.</description><subject>Chronic Disease - therapy</subject><subject>chronic illness</subject><subject>Chronic illnesses</subject><subject>Chronically ill</subject><subject>health care</subject><subject>Health care delivery</subject><subject>Health care industry</subject><subject>Health insurance</subject><subject>Health insurance industry</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Management</subject><subject>Measurement</subject><subject>Medical care</subject><subject>Medical treatment</subject><subject>Methods</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Patient Care Team</subject><subject>Patient-Centered Care</subject><subject>Program Evaluation</subject><subject>quality</subject><subject>Quality of Health Care - standards</subject><subject>Quality of service</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>systems</subject><subject>Time Factors</subject><subject>Total Quality Management - methods</subject><subject>Total Quality Management - organization & administration</subject><subject>United States</subject><issn>0017-9124</issn><issn>1475-6773</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkt9v0zAQxyMEYmXwzBuKkEBDWjb_SpzwgFRFo61WGNAhJF4s1720Hk5c7GTQ_x53rcqKKmE_WDp_7nt39jeKnmN0hsM6x4ynScY5PUMIseJB1NtFHkY9hDBPCkzYUfTE-5uA5DRnj6MjTDAlGcp60fe-9-B9DU0b2youF842WsUjY5oQjkvpID7pl6Pyzdu4H39yUrVaSRNfW2vi1sYfQPouMJ87aXS7ikf10tlbWOs9jR5V0nh4tj2Po6_vL67LYTK-GozK_jhRHKVFkslKEV5linOW5pAyiQo-zVOSo1SqGScky6sCFDBV8SkhCPHQOZ9ROpP5LGP0OHq30V120xpmKpR20oil07V0K2GlFvs3jV6Iub0VmFGWZSQIvN4KOPuzA9-KWnsFxsgGbOcFxwWlhNAAvvwHvLGda8JwgmDMGcrv2jndQHNpQOimsqGomkMDobZtoNIh3M-LjBW8WBdPDuBhz6DW6hB_sscHpIXf7Vx23ot8MN5DTw-hyhoDcxDhE8qrPfzVPXwB0rQLb03Xatv4Pe58wylnvXdQ7Z4aI7F2pVh7UKw9KO5cGTJe3P-hv_zWhgFgG-BXGHb1Pz0xvJh82ehu3077MNguTbofgaYh59vHgRheknQyybC4pH8AYY72xQ</recordid><startdate>200206</startdate><enddate>200206</enddate><creator>Bonomi, Amy E.</creator><creator>Wagner, Edward H.</creator><creator>Glasgow, Russell E.</creator><creator>VonKorff, Michael</creator><general>Blackwell Science, Ltd</general><general>Health Research and Educational Trust</general><general>Blackwell Publishing Ltd</general><general>Blackwell Science Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>7QJ</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200206</creationdate><title>Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement</title><author>Bonomi, Amy E. ; Wagner, Edward H. ; Glasgow, Russell E. ; VonKorff, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c7059-6afc27f6c77458e54a097b852805acd72268f9ece4cf7b220076067d33da8d643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Chronic Disease - therapy</topic><topic>chronic illness</topic><topic>Chronic illnesses</topic><topic>Chronically ill</topic><topic>health care</topic><topic>Health care delivery</topic><topic>Health care industry</topic><topic>Health insurance</topic><topic>Health insurance industry</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Management</topic><topic>Measurement</topic><topic>Medical care</topic><topic>Medical treatment</topic><topic>Methods</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Patient Care Team</topic><topic>Patient-Centered Care</topic><topic>Program Evaluation</topic><topic>quality</topic><topic>Quality of Health Care - standards</topic><topic>Quality of service</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>systems</topic><topic>Time Factors</topic><topic>Total Quality Management - methods</topic><topic>Total Quality Management - organization & administration</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bonomi, Amy E.</creatorcontrib><creatorcontrib>Wagner, Edward H.</creatorcontrib><creatorcontrib>Glasgow, Russell E.</creatorcontrib><creatorcontrib>VonKorff, Michael</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bonomi, Amy E.</au><au>Wagner, Edward H.</au><au>Glasgow, Russell E.</au><au>VonKorff, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement</atitle><jtitle>Health services research</jtitle><addtitle>Health Serv Res</addtitle><date>2002-06</date><risdate>2002</risdate><volume>37</volume><issue>3</issue><spage>791</spage><epage>820</epage><pages>791-820</pages><issn>0017-9124</issn><eissn>1475-6773</eissn><coden>HESEA5</coden><abstract>Objective. To describe initial testing of the Assessment of Chronic Illness Care (ACIC), a practical quality‐improvement tool to help organizations evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas: community linkages, self‐management support, decision support, delivery system design, information systems, and organization of care.
Data Sources. (1) Pre‐post, self‐report ACIC data from organizational teams enrolled in 13‐month quality‐improvement collaboratives focused on care for chronic illness; (2) independent faculty ratings of team progress at the end of collaborative.
Study design. Teams completed the ACIC at the beginning and end of the collaborative using a consensus format that produced average ratings of their system's approach to delivering care for the targeted chronic condition. Average ACIC subscale scores (ranging from 0 to 11, with 11 representing optimal care) for teams across all four collaboratives were obtained to indicate how teams rated their care for chronic illness before beginning improvement work. Paired t‐tests were used to evaluate the sensitivity of the ACIC to detect system improvements for teams in two (of four) collaboratives focused on care for diabetes and congestive heart failure (CHF). Pearson correlations between the ACIC subscale scores and a faculty rating of team performance were also obtained.
Results. Average baseline scores across all teams enrolled at the beginning of the collaboratives ranged from 4.36 (information systems) to 6.42 (organization of care), indicating basic to good care for chronic illness. All six ACIC subscale scores were responsive to system improvements diabetes and CHF teams made over the course of the collaboratives. The most substantial improvements were seen in decision support, delivery system design, and information systems. CHF teams had particularly high scores in self‐management support at the completion of the collaborative. Pearson correlations between the ACIC subscales and the faculty rating ranged from .28 to .52.
Conclusion. These results and feedback from teams suggest that the ACIC is responsive to health care quality‐improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science, Ltd</pub><pmid>12132606</pmid><doi>10.1111/1475-6773.00049</doi><tpages>30</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Chronic Disease - therapy chronic illness Chronic illnesses Chronically ill health care Health care delivery Health care industry Health insurance Health insurance industry Hospitals Humans Management Measurement Medical care Medical treatment Methods Outcome and Process Assessment (Health Care) Patient Care Team Patient-Centered Care Program Evaluation quality Quality of Health Care - standards Quality of service Statistical analysis Studies systems Time Factors Total Quality Management - methods Total Quality Management - organization & administration United States |
| title | Assessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement |
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