Experiences With the Academic Chronic Care Collaborative

Abstract

W e recently participated in the Academic Chronic Care Collaborative (ACCC) sponsored by the Institute for Improving Clinical Care (IICC), a division of the Association of American Medical Colleges (AAMC). This collaborative, led by Dr. David Stevens (Director, IICC, Washington, D.C.) and Dr. Edward Wagner (Director of the McColl Institute for Healthcare Innovation, Seattle, Wash.), involved 22 academic medical centers instituting the Chronic Care Model. This model, developed by Dr. Wagner and his colleagues, identifies the essential components for chronic illness care: the community, the health system, selfmanagement support, delivery system design, decision support, and clinical information systems.1 Each of the teams involved chose a chronic disease, identified a target population, and worked independently to implement the principles of the Chronic Care Model. The underlying goal was to improve chronic illness care. Our team at Vanderbilt University chose diabetes as our target condition and developed a registry of patients for tracking. The collaborative did not provide funding to the participating institutions. Interestingly, this did not seem to limit participation, but rather helped to solidify commitment because local resources were required. With the help of IICC, we selected measures to be tracked within our population and began establishing our baseline rates of adherence. Hemoglobin A1c, LDL cholesterol, blood pressure, and comprehensive foot exams were among the eight measures we selected. All of the teams reported their measures monthly (and publicly!) and participated in conference calls and face-to-face meetings to discuss strategies, successes, and failures. We …