To improve diabetes care at primary level in Mexico through an integrated clinical approach and enhanced health care teamwork
Through its position as a leading public health/health system research institute, INSP seeks to pilot a model on ‘clinical pathways’ to improve diabetes care at the primary care/community level, with emphasis on HCP capacity building and unit workflows, and on clinical outcomes, through following activities:
- Development of an ‘integrated clinical pathways’ model based on system assessment and data analysis, incl. of the specific areas targeted in the two states aiming at both highly urbanised and rural areas; Model development to be undertaken jointly with health authorities and to include monitoring frameworks and review workshops.
- Implementation of the model at targeted health facilities incl. training of HCPs at each primary unit with emphasis on a ‘collaborative approach’ to integrated care; HCPs to be provided necessary tools and tuition within ‘best practices’; Baseline data to be collected.
- Continuous on-site monitoring of workflows and patient adherence, clinical outcomes and follow up mechanisms, in order to acquire and collect comprehensive data and observations.
- Complete the ‘operational research’ incl. model material and guideline based on results achieved; Final review with state and federal level health authorities to assess scale-up potential. Scientific papers also to be published.
- 7 urban and 2 primary health centres, located in Estado de Mexico and Campeche states respectively, provided capacity building incl. training of multidisciplinary teams
- 100 physicians and 200 nurses trained
- At least 6,000 diabetes patients provided improved care according to the new unit workflows piloted; a range of clinical indicators to be monitored