How High-Performing Practices Improved Diabetes Care Quality?

Michael E. Johansen; Jonathan Yun

doi:10.1370/afm.3032

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

What code is in the image? *

Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

RE: How High-Performing Practices Improved Diabetes Care Quality?
Micha Jongejan and Rimke C Vos

Published on: 19 August 2024

Published on: (19 August 2024)
Page navigation anchor for RE: How High-Performing Practices Improved Diabetes Care Quality?
RE: How High-Performing Practices Improved Diabetes Care Quality?
Micha Jongejan, Resident Internal Medicine, PhD student, Department of Public Health & Primary Care, Leiden University Medical Center, The Hague, the Netherlands;
Other Contributors:
Rimke C Vos, Associate Professor
Thank you for this insightful mixed-method study assessing strategies of best practices for change management of diabetes care in the primary care setting. We discussed your article with great interest during our recent journal club meeting with our department of Public Health and Primary Care in The Hague, the Netherlands. This study could assist other practices in improving their diabetes care. As stated by the WHO, non-communicable diseases like diabetes are one of the 21st century’s major health challenges. This study highlights the complexity of changing quality of care, demonstrating that there is not one answer or easy solution.
We underscore the importance of standardizing care to improve quality of care. Additionally, we support initiatives for pro-active outreach to patients with inadequately managed disease, which aligns with the Population Health Management approach.
Considering Population Health Management we were particularly curious about whether and how the top-performing practices would stratify their population in low, intermediate and high-risk panels and how appropriate care could look like when taking into account social determinants of health and contextual factors. The percentage of patients receiving optimal diabetes care score might not capture the quality of care provided to high-risk patients. Improvement in the quality of care of these patients could yield the highest impact. However, these patients are often hardest to reach and tre...
Show More

Thank you for this insightful mixed-method study assessing strategies of best practices for change management of diabetes care in the primary care setting. We discussed your article with great interest during our recent journal club meeting with our department of Public Health and Primary Care in The Hague, the Netherlands. This study could assist other practices in improving their diabetes care. As stated by the WHO, non-communicable diseases like diabetes are one of the 21st century’s major health challenges. This study highlights the complexity of changing quality of care, demonstrating that there is not one answer or easy solution.
We underscore the importance of standardizing care to improve quality of care. Additionally, we support initiatives for pro-active outreach to patients with inadequately managed disease, which aligns with the Population Health Management approach.
Considering Population Health Management we were particularly curious about whether and how the top-performing practices would stratify their population in low, intermediate and high-risk panels and how appropriate care could look like when taking into account social determinants of health and contextual factors. The percentage of patients receiving optimal diabetes care score might not capture the quality of care provided to high-risk patients. Improvement in the quality of care of these patients could yield the highest impact. However, these patients are often hardest to reach and treat. Therefore, we are especially interested in learning about successful strategies for change management tailored to high-risk patients. How do top-performing practices ensure that high-risk patients receive the care they need while avoiding unnecessary care for those at low risk? Are there specific strategies particularly effective in this subgroup? And were other strategies successful in more deprived areas? Understanding these strategies could provide valuable insights for improving care considering both care gaps as care waste.

We thank you once again for your valuable study.
Show Less

Competing Interests: None declared.