AIMS: We evaluated the impact of a continuous quality improvement effort implemented by a network of Italian diabetes clinics operating in the national healthcare system. METHODS: This was a controlled before-and-after study involving 95 centres, of which 67 joined the initiative since 2004 (group A) and 18 were first involved in 2007 (group B, control). All centres used electronic medical record systems. Information on quality indicators was extracted for the period 2004-2007. Data were centrally analysed anonymously and results were published annually. Each centre's performance was ranked against the 'best performers'. We compared quality indicators between the two groups of centres over 4 years. RESULTS: Over 100 000 Type 2 diabetes mellitus patients were evaluated annually. The proportion of patients with glycated haemoglobin levels < 7% increased by 6% in group A (2007-2004 difference) and by 1.3% in group B. The proportion of patients with low-density lipoprotein-cholesterol < 100 mg/dl improved by over 10% in both groups. The rate of patients with blood pressure values < or = 130/85 mmHg increased in group A (+6.4%), but not in group B (-1.4%). The use of insulin increased in group A only (+5.2%), while the use of statins increased by over 20% in both groups. CONCLUSIONS: A physician-led quality improvement effort, based on the systematic evaluation of routine data, is effective in improving the performance of a large number of diabetes clinics. The small percentage increase in the number of patients at target, if applied to large numbers of patients, would translate into a significant impact on public health.
AIMS: We evaluated the impact of a continuous quality improvement effort implemented by a network of Italian diabetes clinics operating in the national healthcare system. METHODS: This was a controlled before-and-after study involving 95 centres, of which 67 joined the initiative since 2004 (group A) and 18 were first involved in 2007 (group B, control). All centres used electronic medical record systems. Information on quality indicators was extracted for the period 2004-2007. Data were centrally analysed anonymously and results were published annually. Each centre's performance was ranked against the 'best performers'. We compared quality indicators between the two groups of centres over 4 years. RESULTS: Over 100 000 Type 2 diabetes mellituspatients were evaluated annually. The proportion of patients with glycated haemoglobin levels < 7% increased by 6% in group A (2007-2004 difference) and by 1.3% in group B. The proportion of patients with low-density lipoprotein-cholesterol < 100 mg/dl improved by over 10% in both groups. The rate of patients with blood pressure values < or = 130/85 mmHg increased in group A (+6.4%), but not in group B (-1.4%). The use of insulin increased in group A only (+5.2%), while the use of statins increased by over 20% in both groups. CONCLUSIONS: A physician-led quality improvement effort, based on the systematic evaluation of routine data, is effective in improving the performance of a large number of diabetes clinics. The small percentage increase in the number of patients at target, if applied to large numbers of patients, would translate into a significant impact on public health.
Authors: Salvatore De Cosmo; Francesca Viazzi; Antonio Pacilli; Carlo Giorda; Antonio Ceriello; Sandro Gentile; Giuseppina Russo; Maria C Rossi; Antonio Nicolucci; Pietro Guida; Daniel Feig; Richard J Johnson; Roberto Pontremoli Journal: Clin J Am Soc Nephrol Date: 2015-09-04 Impact factor: 8.237
Authors: Maria C E Rossi; Giuseppe Lucisano; Marco Comaschi; Carlo Coscelli; Domenico Cucinotta; Patrizia Di Blasi; Giovanni Bader; Fabio Pellegrini; Umberto Valentini; Giacomo Vespasiani; Antonio Nicolucci Journal: Diabetes Care Date: 2011-02 Impact factor: 19.112
Authors: Maria Chiara Rossi; Maria Rosaria Cristofaro; Sandro Gentile; Giuseppe Lucisano; Valeria Manicardi; Maria Franca Mulas; Angela Napoli; Antonio Nicolucci; Fabio Pellegrini; Concetta Suraci; Carlo Giorda Journal: Diabetes Care Date: 2013-07-08 Impact factor: 19.112
Authors: Antonio Nicolucci; Maria C Rossi; Fabio Pellegrini; Giuseppe Lucisano; Basilio Pintaudi; Sandro Gentile; Giampiero Marra; Soren E Skovlund; Giacomo Vespasiani Journal: Springerplus Date: 2014-02-12
Authors: Giuseppina Russo; Basilio Pintaudi; Carlo Giorda; Giuseppe Lucisano; Antonio Nicolucci; Maria Rosaria Cristofaro; Concetta Suraci; Maria Franca Mulas; Angela Napoli; Maria Chiara Rossi; Valeria Manicardi Journal: Int J Endocrinol Date: 2015-03-19 Impact factor: 3.257
Authors: Marco Gallo; Edoardo Mannucci; Salvatore De Cosmo; Sandro Gentile; Riccardo Candido; Alberto De Micheli; Antonino Di Benedetto; Katherine Esposito; Stefano Genovese; Gerardo Medea; Antonio Ceriello Journal: BMJ Open Diabetes Res Care Date: 2015-08-12