Other Cardiovascular Cluster Resources
Collaboratives/Partnerships/Consortiums
Chronic Disease Treatment Programs/Clinics

Clinical Diabetes-Focused Resources

Self Management Resources:

• Goal Setting Training Guide
• "My A1c" Handout
  "My LDL" Handout
• Diabetes Fact Sheet by Harlem Hospital Center
• Diabetes Flow Sheet by Contra Costa Health Services
• My Diabetes Record by Contra Costa Health Services (A sheet to record patients lab
  values so patients can track their own progress.)
• Diabetes Health Record Card (English/Spanish) by the CA Diabetes Prevention & Control Program
• Action Plan Log by Silver Avenue Family Center
• Action Plan with Pictures (English) by Ocean Park Health Center
• Action Plan with Pictures (Chinese) by Ocean Park Health Center
• Patient Education and Self-Management Tools from Community Health Association of Mountain/Plains States
• Patient Health Issues Sheet
• Self-Management Goal Sheet by Roybal Comprehensive Health Clinic
• Self-Management Goal Sheet - Spanish by Roybal Comprehensive Health Clinic
• Self-Management Form - English by Winton Wellness Center
• Self-Management Form - Spanish by Winton Wellness Center
• The ABC's of Diabetes: Diabetic Patient Report Card by Harbor Family Medicine Lomita
• Self-Management Goal Sheet - English
• Self-Management Goal Sheet - Spanish
• Health Bubbles for Patients to Discuss with Provider
• Diabetes Action Plan (English & Spanish) by Castro-Mission Health Center

Group Visits:

• Improving Chronic Illness Care Free Group Visits Tool Kit
• Improving Chronic Illness Care Group Visits Starter Kit
• Kaiser's Group Appointments: Effective Clinical Management Video
• Kaiser's Group Appointments: Leading Group Visits Video
• Chapter on "Group medical visits and other non-traditional encounters"
• Group Consent Form from Richmond Health Center
• Shared Medical Appointment Confidentiality Agreement by the University of California, Davis Medical Center
• Outpatient Group Progress Note by San Francisco General Hospital
• Diabetes Group Pharmacist Progress Note by San Francisco General Hospital
• Training Guide for Group Medical Visits (IDEALL Project)
• Group Visit Progress Note San Francisco Community Health Network

Protocols and Standing Orders:

• Lab Referral Protocol from San Mateo Medical Center
• Automated Telephone Disease Management Protocol (IDEALL Project)
• Intensification of Treatment Protocol by The Christ Hospital
• Standing Order for Diabetes Care by Richmond Health Center
• Standing Orders for Diabetes Care Form by St. Peter Family Medicine

Flowsheets:

• DM Care Date Collection Sheet by Chinatown Public Health Center
• Diabetes Rx Prompt by Richmond Health Center
• Diabetes Flow Sheet by Contra Costa Health Services

Depression Resources:

• MacArthur Initiative on Depression and Primary Care Toolkit
• Relationship of Depression and DiabetesSelf-Care, Medication Adherence & Preventative Care
• Depression Screening Survey

Foot Check Resources:

• Free English & Spanish Diabetic Foot Check Posters from Lumetra (Contractor to CMS)
• Foot Check Stamp by San Mateo Medical Center
• Foot Check Sign 1 by Silver Avenue Family Center
• Foot Check Sign 2 by Silver Avenue Family Center
• Foot Check Sign 3 by Silver Avenue Family Center
• Foot Check Exam Process by Washington State Primary Care Practice
• Foot Care Information by Familydoctor.org
• Foot Exam Sheet (page 51) by The Journal of Foot & Ankle Surgery
• Preventing Foot Ulcers by JAMA

Multilingual & Multicultural Health Education Resources:

• Consumer Health Brochures in Multiple Languages
• Diabetes Australia
• Diabetes Information in Simplified Chinese
• Diabetes Information in Traditional Chinese
• Diversity Health Institute Clearinghouse
• Ethnomed
• NSW Multicultural Health Communication Service
• National Network of Libraries of Medicine Multilingual Page
• Spiral by Health Topics (includes a section on diabetes)
• Asian American Health
• Lumetra Bilingual Patient Education Booklet

Other Diabetes Resources:

• National Diabetes Education Program
• American Diabetes Association, 1-800-342-2383
• Diabetes Public Health Resource, Centers for Disease Control & Prevention
• U.S. National Institute of Diabetes & Digestive & Kidney Diseases of the National Institutes of Health
• “Diabetes: The Impact of Multiple Chronic Conditions.” Partnership for Solutions: Better Lives for People with Chronic Conditions. May 2002 (PDF)
• Diabetes Bibliography: Improving Chronic Illness Care, The Robert Wood Johnson Foundation
• California Diabetes Prevention & Control Program
• American College of Physicians Diabetes Care Guide (Can request 5 FREE copies)

Chronic Illness Care (General):

• Accelerating Chronic Illness Improvement by Dr. Edward Wagner
• Chronic Care Model Audio Presentation as narrated by Dr. Edward Wagner
• Chronic Care Bibliography (Improving Chronic Illness Care, The Robert Wood Johnson Foundation)
• CareLink (A monthly, online publication by the National Chronic Care Consortium)
• Data Collection Instruments, Improving Chronic Illness Care Evaluation, RAND Health Program
• Self-Management Support Bibliography (Improving Chronic Illness Care, The Robert Wood Johnson Foundation)
• Chronic Disease Prevention & Health Promotion Grants to States, Chronic Disease Directors
• Improving Chronic Illness Care Program, Robert Wood Johnson Foundation
• Chronic Illness Management, MacColl Institute for Healthcare Innovation
• Institute for Healthcare Improvements: Chronic Care
• Chronic Disease Care, California HealthCare Foundation
• National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
• The Observatory on Health Care for Chronic Conditions, World Health Organization
• Chronic Disease Directors

Other Cardiovascular Cluster ResourcesTOP

Heart Disease:

• Kaiser Permanente's Healthy Heart
• American Heart Association, 1-800-242-8721
• National Heart, Lung, and Blood Institute, 1-301-496-4236
• Cardiovascular Disease, Centers for Disease Control & Prevention
• “Cardiovascular Disease: The Impact of Multiple Chronic Conditions.” Partnership for Solutions: Better Lives for People with Chronic Conditions. May 2002 (PDF)
• Heart Failure Bibliography (Improving Chronic Illness Care, The Robert Wood Johnson Foundation)
• Caring for your Heart: Living Well with Heart Failure by UCSF

High Cholesterol:

• Cardiovascular disease, Centers for Disease Control & Prevention
• “High Cholesterol: Common Comorbidities.” Partnership for Solutions: Better Lives for People with Chronic Conditions. July 2004 (Word)

Hypertension:

• Cardiovascular disease, Centers for Disease Control & Prevention
• “Hypertension: The Impact of Multiple Chronic Conditions.” Partnership for Solutions: Better Lives for People with Chronic Conditions. July 2004
• Hypertension Bibliography (Improving Chronic Illness Care, The Robert Wood Johnson Foundation)

Obesity:

• Overweight & Obesity, Centers for Disease Control & Prevention
• American Obesity Association
• “Resource Guide for Nutrition and Physical Activity Interventions to Prevent Obesity and Other Chronic Diseases” Centers for Disease Control & Prevention, Department of Health & Human Services (PDF)

Smoking:

• American Cancer Society, 1-800-227-2345
• American Lung Association, 1-800-586-4872
• National Cancer Institute
• National Heart, Lung, and Blood Institute, 1-301-496-4236
• “Lung Cancer: The impact of multiple chronic conditions.” Partnership for Solutions: Better Lives for People with Chronic Conditions (Word)

TOP Other Collaboratives/Partnerships/Consortiums

• National Chronic Care Consortium
• California Quality Improvement Collaborative
• Yes We Can Urban Asthma Partnership, San Francisco
• Community Health Center Network of the East Bay (CHCN)
• Edward R. Roybal Comprehensive Health Center Diabetes Clinic, Los Angeles
• Bureau of Primary Health Care Health Disparity Collaboratives
• Partnership for Solutions: Better Lives for People with Chronic Conditions (John Hopkins University and The Robert Wood Johnson Foundation)
• California Primary Care Association Health Disparities Collaboratives
• Oregon Diabetes Collaborative
• Bureau of Primary Health Care Health Disparity Collaboratives
• Community Clinic Association of Los Angeles County
• San Diego Council of Community Clinics
• Community Health Partnership of Santa Clara County
• Diabetes Coalition of Santa Clara County
• Central Valley Health Network
• Whittier Institute for Diabetes
• Health Disparities Collaboratives

TOP Chronic Disease Treatment Programs/Clinics:

• IDEALL Project, San Francisco General Hospital
• Project Dulce Diabetes Program, San Diego
• Community Diabetes Project, Community Health Partnership of Santa Clara County
• Su Salud Disease & Prevention Center, San Joaquin General Hospital
• Diabetes Care Center, Community Medical Center, Fresno