Improving Chronic Disease Management Using a Quality Improvement Coaching Program ...


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Federally Qualified Health Centers are primary care clinics that receive federal funds to provide health services to underserved communities with complex health and social challenges.

These challenges place FQHC patients at highest risk for chronic diseases such as heart disease and diabetes and make treatment and management all the more challenging.

To better equip FQHCs to effectively manage patients with chronic diseases, the Los Angeles County Department of Public Health partnered with the Community Clinic Association of Los Angeles County to launch a three-year quality improvement program with a cohort of five FQHCs to address hypertension, undiagnosed hypertension, high blood cholesterol, diabetes, and chronic kidney disease.

Each participating FQHC was assigned a practice transformation coach who provided them ongoing technical assistance and support to facilitate improvements in clinical practices.

The FQHCs were also provided with trainings to advance their knowledge and skills and encouraged to learn from one another through regular check-ins and online group message board discussions.

Some of the program's barriers included limited provider and care team buy-in for new activities amid competing priorities and high volume of staff turnover.

However, these barriers also served to create new opportunities for innovation and improvements.

All five FQHCs met their performance improvement goals.

The adaptive nature of the program and flexibility and commitment

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