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Changing Systems, Changing Lives: Improving the Quality of Diabetes Care: Preface

The first 20% of the full text of this article appears below.

The Right Care, For Every Patient, Every Time

The goal of health care professionals is to provide the right care to every patient at every clinical encounter. This aphorism reflects the dedication that providers bring to their practice. However, although their intentions are good, their implementation is imperfect. Is the poor implementation a result of a lack of dedication, knowledge, or effort? Absolutely not. Diabetes providers are among the most knowledgeable, committed, and hard working of all health care professionals. The problem is not the people; the problem is the system.

The operating assumption of the medical system is that providers’ competence is the primary determinant of health care quality. Providers graduate from accredited programs, pass certifying examinations, and must satisfy continuing education and other professional licensing requirements. Their competence extends to their knowledge of the standards of care that have been established by their professional organizations. Providers are aware of the standards of care and are largely in agreement with those standards. Despite their knowledge and competence, poor outcomes still exist.

Why hasn’t the competency of individual professionals translated into excellent clinical care? The answer lies in the lack of system capability to support providers in doing what they know should be done. This Diabetes Spectrum From Research to Practice section focuses on our belief that optimal clinical outcomes are produced when individual competency is implemented through a capable system.

In our first article (p. 92), David K. McCulloch MD, FRCP, and his colleagues at the MacColl Institute for Healthcare Innovation at Group . . . [Full Text of this Article]

Quality is Not Optional

Every System Is Perfectly Designed to Produce Its Current Results.

Profession-Based Practice

Clinical Efficacy Versus Clinical Effectiveness

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