BMJ  2005;330:612-613 (19 March), doi:10.1136/bmj.330.7492.612

Editorial

Nurses as leaders in chronic care

Their role is pivotal in improving care for chronic diseases

The first 150 words of the full text of this article appear below.

The chronic care model is widely accepted as a standard for improving care for people with chronic conditions.¹ In the United States, projects to put the chronic care model into practice often centre around doctors. Yet the healthcare literature and the experience of many efforts to improve chronic care indicate that nurses, not doctors, are the key to implementing the chronic care model in a patient centred care team. By nature of their education and role, nurses are in a position to champion transformation of chronic care. In many nations, but not in the United States, nurses have been taking this central role for decades.^w1

The essence of the chronic care model is the interaction between an informed, activated patient and a prepared, proactive practice team.^w2 Indeed, such a team is nearly always needed to enable patients to become adequately informed and activated. What is the record of doctors . . . [Full text of this article]

Department of Family and Community Medicine, University of California at San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA (Tbodenheimer@medsch.ucsf.edu)

Department of Family and Community Medicine, University of California at San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA

Whatcom County Pursuing Perfection Project, Bellingham, WA 98225, USA

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