Use of Collaboration to Improve Outcomes in Chronic Disease: An Overview
David J. Castle
Chronic disease and collaboration (people The aim of this article is to outline four approaches to collaboration - epidemiologically focused collaborations, research-based consortiums, organizational-change collaborations, and patient-focused disease management strategies - currently employed to address the growing problem of chronic disease. We highlight the types of collaborations that may be of value when considering useful approaches to identifying evidence-based practice and how these might be implemented to improve patient outcomes, and deal with some potential barriers to change. We identified 67 suitable papers that were grouped into four broad categories. Because of the variety of collaborations addressed, we targeted our review to highlight key groups as illustrative examples for discussion. We found that epidemiological collaborations can useful for collecting and analyzing large amounts of data to provide evidence and develop guidelines for ensuring the most effective treatment is provided to the patient. They are also an effective tool for identifying barriers to evidence based treatments, such as access pathways to care. Collaborative Research Consortiums can provide a method for health providers to research or source best evidence and develop strategies for implementing specific evidence-based treatments into practice across a range of services within a given region. They also appear to be effective in raising awareness of specific issues (such as depression) in healthcare that can impact on patient outcomes. Organizational-change consortiums appear to provide an important mechanism that addresses to a degree, the translation of evidence developed by other research methods into clinical practice in a targeted step-wise strategy. Patient-focused disease management programs that work in a person-centered method, have demonstrated some capacity to create sustainable change once interventionist treatments have been identified; however, long-term management is required to maintain or improve outcomes. All of these methods have shown benefit, but are limited by their own particular focus. To really harness their strengths, requires organizations to understand the potential value of all these methods and to develop a whole-of-health approach to implementing evidence into clinical practice if long-term sustainability is to become an achievable goal. DOI: 10.2165/0115677-200816060-00003
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