Table 2.

Chronic Care Model’s Essential Elements and Ostomy Intervention Elements

Essential Elements	Ostomy Intervention Component
1. The Community -- Resources and Policies	Identify local culturally competent resources and compile a location-specific resource compendium for patients and their families
2. The Health System -- Organization of Care	Keeping patients as healthy as possible through planning, proven strategies. and culturally competent care management
3. Culturally Competent Self-Management Support	Offer self-efficacy enhancing, evidence-based self-care information and peer support-5 session program using Kate Lorig’s chronic disease self-management program
4. Delivery System Design	Organize group classes (see above) in lieu of unstructured, reactive care; train and utilize volunteer peer educators in culturally competent care
5. Decision Support	Peri-surgical pathways and standing orders*
6. Clinical Information Systems	Integrate clinical care pathways, standing orders and referral into information system. Assure primary care clinician is trained in special needs of ostomates. Provide electronic communications connections between providers and patients.*

^*Components not feasible in this pilot study, but which will be added in follow-up trial