title: Lessons learned from a collaborative to improve care for patients with diabetes in 17 community health centers, Massachusetts, 2006.
abstract: BACKGROUND
  In 2006, the Massachusetts League of Community Health Centers convened a collaborative to systematically improve health care delivery for patients with diabetes in 17 community health centers. Our goal was to identify facilitators of and barriers to success reported by teams that participated in this collaborative.
  
  
  METHODS
  The collaborative's activities lasted 13 months. At their conclusion, we interviewed participating team members. We asked about their teams' successes, challenges, and take-home messages for future collaborative efforts. We organized their responses into common themes by using the Chronic Care Model as a framework.
  
  
  RESULTS
  Themes that emerged as facilitators of success included shifting clinic focus to more actively involve patients and to promote their self-management; improving the understanding and implementation of professional guidelines; and expanding staff roles to accommodate these goals. Patient registries were perceived as beneficial but lacking adequate technical support. Other barriers were staffing and time constraints.
  
  
  CONCLUSIONS
  Cooperative efforts to improve health care delivery for people with diabetes may benefit from educating the health care team about guidelines, establishing a stronger role for the patient as part of the health care team, and providing adequate technical instruction and support for the use of clinical databases.
authors.affiliation: University of Massachusetts Medical School, 55 Lake Ave N, Benedict Bldg, Worcester, MA 01655, USA. celeste.lemay@umassmed.edu
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Lemay
authors.forename: Brianne M
authors.initials: BM
authors.lastname: Beagan
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Ferguson
authors.forename: J Lee
authors.initials: JL
authors.lastname: Hargraves
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration*; D003153:Community Health Services / Q000379:methods*; D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D017063:Outcome Assessment, Health Care; D012648:Self Care