Improving Chronic Illness Care Evaluation (ICICE)

CONCLUDED STUDY - conducted 1999-2003

More RAND Research on Chronic Diseases and Conditions

A Robert Wood Johnson-funded evaluation of the effectiveness of the Chronic Care Model and the IHI Breakthrough Series Collaborative in improving clinical outcomes and patient satisfaction with care.

About the Study

Collaboratives offer participating organizations a menu of "best practices" along with a method for actually implementing change. Health systems working on improvement repeatedly report that "implementation is the hard part." While best clinical practice builds on a well-supported research base, there are few controlled studies of implementation.

To fill this gap, the Robert Wood Johnson Foundation funded a four-year study of three Chronic Illness Care Collaboratives. Participating organizations use the Collaborative method to implement an evidence-based system of chronic illness care called the Chronic Care Model (CCM). The Chronic Care Model was developed by researchers at the Improving Chronic Illness Care (ICIC) at the MacColl Institute for Healthcare Innovation at the Group Health Cooperative.

The evaluation was conducted by a multidisciplinary research team from RAND and the University of California at Berkeley in cooperation with the Institute for Healthcare Improvement, Improving Chronic Illness Care, and the sponsors of the Washington State Diabetes Collaborative.

Our study was designed to provide practical guidance to health care organizations seeking to improve care for patients with chronic disease. The evaluation team conducted consistent, independent assessments across participating sites, and addressed the following critical questions about organizational efforts to implement changes and improve care:

  • Are organizations enrolled in the Collaborative able to make significant changes in their systems for delivering chronic illness care?
  • What organizational and team factors are associated with successful change efforts?
  • Does successful implementation of the Chronic Care Model lead to better processes and outcomes of care, including patient health status, patient and provider satisfaction, utilization and costs?