Advanced Comprehensive Diabetes Care (ACDC)
Last updated
Share PrintACDC is a nurse-administered telehealth intervention for Veterans with poor diabetes control despite standard VA diabetes care. ACDC augments standard VA Home Telehealth services with diabetes self-management support and clinician-guided medication management. Critically, ACDC is specifically designed to use only existing VA staffing and infrastructure, so can be easily implemented in practice. In a randomized trial, ACDC improved hemoglobin A1c by an average of 1% vs. usual care, and by ~2% among engaged Veterans. ACDC’s real-world effectiveness has been confirmed at multiple VA sites. Rigorous qualitative testing shows that ACDC is well-liked and greatly appreciated by Veterans and participating staff.
Origin:
December 2013, Durham VA Medical Center
Adoptions:
3 successful, 7 in-progress, 1 unsuccessful
Awards and Recognition:
Diffusion of Excellence Promising Practice, Rural Promising Practice, VHA Shark Tank Winner
Recent Updates
Overview
The problem
The solution
ACDC uses only existing VA clinical staffing, equipment, and infrastructure, and can be fully implemented at any VA site within just a ... Via an easy-to-implement collaboration between the VA Home Telehealth program and clinical pharmacy, ACDC aligns telemonitoring, self-management support, and medication management services around participating Veterans.
ACDC uses only existing VA clinical staffing, equipment, and infrastructure, and can be fully implemented at any VA site within just a few months. See more
The results
Metrics
- Mean hemoglobin A1c reduction 1.4% (n=230)
- Qualitative Veteran and staff feedback is consistently positive
- Implementation is cost-neutral in the short-term, and is likely to be cost-saving as the benefits of diabetes control accrue
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Images
Above:
During the 2018 Shark Tank competition, the VA Diffusion of Excellence Initiative selected ACDC as a winner, or Gold Status Practice.
Implementation
Departments
- Nursing services
- Pharmacy
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Support Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| Home Telehealth nurse time availability | Recommend that facility allocate up to 0.5 FTE for one Home Telehealth nurse (depending on scale of intervention) |
| Clinical Pharmacy Specialist time availability | Recommend that facility allocate up to 0.25 FTE for one Clinical Pharmacy Specialist (depending on scale of intervention) |
| Volume of appropriate patients | ACDC is optimal for facilities struggling with diabetes control metrics |
About
Origin story
Original team
Susanne Danus
Project Coordinator
Matthew Crowley
Project Leader
Comment
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