Article Summary Randomized trial of quality improvement intervention to improve diabetes care in primary care settings. O’Connor PJ, Desai J, Solberg LI, et al. Diabetes Care. 2005;28:1890-1897. Objective: To evaluate the impact of a quality improvement (QI) intervention on the quality of diabetes care at primary care clinics. Methods: Twelve primary care clinics were recruited for the study. Patients aged >19 years diagnosed with diabetes (2 or more ICD-9 codes of 250.xx within a 12-month period) were eligible for analysis. Clinic managers and medical directors were trained on the IDEAL (Improving Care for Diabetes Through Empowerment, Active Collaboration, and Leadership) model and 7-step QI process. Over a 42-month period, the QI program involved 3 chronological phases. Data were obtained from baseline and follow-up surveys of clinic staff and diabetic patients. Patient medical records were reviewed for defined 12-month periods before and after the intervention. Two composite measures of care were assessed: the percentage of patients with annual tests for A1C, low-density lipoprotein (LDL), and blood pressure, and the percentage of patients with annual screening for eye, foot, or kidney complications. A composite measure of outcomes of care was also determined that included the percentage of patients who had A1C <8%, LDL <130 mg/dL, and systolic blood pressure <135 mm Hg. Results: Preintervention and postintervention surveys were completed by 754 adults with diabetes. No statistically significant improvements over time in A1C or blood pressure were reported. Compared with control clinics, the intervention clinics had significantly improved test rates for A1C, LDL, and blood pressure. Conclusion: Although the process changes reported in this study did not translate into population-wide improvement, the study was powerful enough to detect significant changes in some important processes of diabetes care.