Observational studyAnnals of family medicine
Strategies and Factors Associated With Top Performance in Primary Care for Diabetes: Insights From a Mixed Methods Study.
Observational study in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Sustained Improvement in Urine Testing Quality Indicator Through an Audit-and-Feedback Intervention in Japanese Primary Care: A Before-and-After Study.Journal of general and family medicine · 2026Article
- Care Management Processes Important for High-Quality Diabetes Care.Diabetes care · 2023Article
- Implementing primary care diabetes prevention for women with previous gestational diabetes: a mixed-methods study.Family practice · 2022Article
- Quality and team care response to the pandemic stresses in high performing primary care practices: A qualitative study.PloS one · 2022Article
- Mixed Methods: Capturing Complexity in Family Medicine Research.Annals of family medicineArticle
- Successful Change Management Strategies for Improving Diabetes Care Delivery Among High-Performing Practices.Annals of family medicineArticle
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Authors and funding
6 authors.
Funding
Abstract
purposeThe aim of this study was to determine what strategies and factors are most important for high performance in the primary care of patients with diabetes.
methodsWe performed a mixed-methods, cross-sectional, observational analysis of interviews and characteristics of primary care clinics in Minnesota and bordering areas. We compared strategies, facilitators, and barriers identified by 31 leaders of 17 clinics in high-, middle-, and low-performance quartiles on a standardized composite measure of diabetes outcomes for 416 of 586 primary care clinics. Semistructured interview data were combined with quantitative data regarding clinic performance and a survey of the presence of care management processes.
resultsThe interview analysis identified 10 themes providing unique insights into the factors and strategies characterizing the 3 performance groups. The main difference was the degree to which top-performing clinics used patient data to guide proactive and outreach methods to intensify treatment and monitor effect. Top clinics also appeared to view visit-based care management processes as necessary but insufficient, whereas all respondents regarded being part of a large system as mostly helpful.
conclusionsTop-performing clinic approaches to diabetes care differ from lower-performing clinics primarily by emphasizing data-driven proactive outreach to patients to intensify treatment. Although confirmatory studies are needed, clinical leaders should consider the value of this paradigm shift in approach to care.
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