title: Complete care at Kaiser Permanente: transforming chronic and preventive care.
abstract: BACKGROUND
  In 2004 Kaiser Permanente Southern California (KPSC) recognized the potential to improve the quality of care. Healthcare Effectiveness Data and Information Set (HEDIS) performance was below what regional leadership aspired to achieve, exceeding the 90th national percentile on only 15 of 34 measures. Beginning in 2005 regional leadership identified several system opportunities to enhance evidence-based, person-focused care. DEVELOPMENT OF COMPLETE CARE: KPSC developed and implemented a comprehensive delivery system redesign and expanded and integrated existing clinical information systems, decision support, work flows, and self-management support-collectively referred to as Complete Care. The goal of Complete Care is to transform care for healthy members, those with chronic conditions, and those with multiple comorbidities. To date, KPSC has applied Complete Care to 26 chronic conditions and areas of preventive and wellness care. Implemented in all care settings and optimizing the roles of all health care team members to maximal scope of practice, Complete Care provides evidence-based, person-focused care addressing a large set of protocol-based health needs for every individual during every encounter within the health care system.
  
  
  RESULTS
  On 51 HEDIS metrics, KPSC improvement using Complete Care averaged 13.0%, compared with 5.5% improvement in the national HEDIS 50th percentile.
  
  
  CONCLUSIONS
  Implementation of Complete Care at KPSC was followed by six-year quality gains that outpaced changes in the HEDIS national percentiles for many measures. Additional care gaps have been included in proactive office encounter checklists; these relate to elder care, advance directives, posthospital care, immunizations, health maintenance, and pregnancy care.
authors.affiliation: Southern California Permanente Medical Group, Pasadena, California, USA. Michael.H.Kanter@kp.org
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kanter
authors.forename: Gail
authors.initials: G
authors.lastname: Lindsay
authors.forename: Jim
authors.initials: J
authors.lastname: Bellows
authors.forename: Alide
authors.initials: A
authors.lastname: Chase
mesh_terms: D002140:California; D002908:Chronic Disease; D015897:Comorbidity; D003191:Comprehensive Health Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D017146:Models, Organizational; D011314:Preventive Health Services / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends