Gaining Resident Buy-In

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Teams found that gaining resident support was integral to successfully implementing the Chronic Care Model. Steps to gain buy in include providing data, letting peers teach peers, and allowing residents to make changes when needed.

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Gaining Resident Buy-In

The approach the Vanderbilt University Medical Center team took in persuading residents to incorporate new concepts of change involved three steps.

Step 1: Confronting the Data—At the beginning of Vanderbilt’s participation in the Academic Chronic Care Collaborative, each resident and attending physician received a practice report presenting performance measure data that were disappointing. Data was examined related to the performance of a recommended annual diabetic foot exam and the proportion of patients with an A1c less than 7, blood pressure less than 130/80 and low-density lipoprotein cholesterol less than 100.

Step 2: Residents Teaching Residents—The group acknowledged the validity of the reports despite initial denial among residents and attending physicians. To help introduce the Chronic Care Model's patient self-management concepts, the group took a self-management workshop led by a resident or peer.

Residents participated in goal-setting exercises that generated a positive discussion among the group, motivated them to learn more about the Chronic Care Model, and resulted in actual behavior changes among individuals in the group.

Step 3: Residents Initiating Change—After completing the self-management workshop, residents planned and led a diabetes group visit. Residents selected five patients to participate in a group teaching discussion during which they worked with patients to update their diabetes health parameters.

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