Transcript Project Status

Health Improvement Consultants:
A Unique Clinical Resource
in West Virginia
Translating the Science
into Useable Tools
Trisha Petitte, RN, BSN, MPA
Marie Gravely, MA, RD, LD, CDE
Nell Stuart, MS, RD, LD, CDE
This presentation was supported by Grant/Cooperative Agreement Numbers
U32/CCU322734 and U59/CCU324180-04, and 1U50DP000675-01 from the
Centers for Disease Control and Prevention.
Its contents are solely the responsibility of the authors and do not necessarily
represent the official views of the Centers for Disease Control and Prevention.
Strategies for
Improving Patient Care
Diabetes Care, 2008 Clinical Practice Guidelines

Improve education to professionals

Deliver self-management education

Adopt practice guidelines

Have guidelines accessible at point of
care

Use tracking systems via electronic
medical record or patient registry
Adapted from Diabetes Care, January 2008
Our Focus

Health Care Improvement

Professional Development

Community Intervention
Health Care Improvement
 Adopt practice guidelines
− Incorporate into clinic practice
 Standing orders
 Diabetes Days
 Quality improvement activities
 Use tracking systems
− Registries
 Demonstrate/promote CDEMS as QI tool
 Assist clinic with CDEMS
implementation/utilization to meet its
needs
 Review CDEMS Summary Data with clinic
staff to identify successes and needs for
improvement
Professional Development
 Improve education to professionals
- The Art and Science of Diabetes Care
(Diabetes Curriculum for Office Staff)
- “Are You Ready?” program
- Promote educational opportunities in the
state
 Diabetes Symposium
 Diabetes Education for the Primary Care
Provider
Professional Development
 Improve education to professionals
- State and national organizations
WV Association of Free Clinics
WV Primary Care Association
WV Association of Diabetes Educators
American Association of Diabetes
Educators
 American Dietetic Association




Community Interventions
 Deliver self-management education
- Promote and assist with





“Help Yourself”
“Dining with Diabetes”
“Are You Ready?”
“Gentle Yoga for All”
Community diabetes support groups
 Identify and promote community
resources
- Clinic to community
- Clinic to clinic
The Picture As
We Got Started
Hancock
Brooke
Ohio
Marshall
Monongalia
Wetzel
Marion
Pleasants
Hampshire
Roane
Hardy
Upshur
Randolph
Pendleton
Webster
Clay
Cabell
Jefferson
Grant
Lewis
Braxton
Putnam
Berkeley
Barbour
Tucker
Cal- Gilmer
houn
Jackson
Mineral
Taylor
Ritchie
Wirt
Mason
Preston
Dodd- Harrison
ridge
Wood
Morgan
Tyler
Kanawha
Pocahontas
Nicholas
Wayne
Lincoln
Boone
Fayette
Greenbrier
Logan
Logan
Mingo
Raleigh
Wyoming
Summers
Mercer
McDowell
Monroe
September, 2007
The Picture Now
Hancock
Brooke
Ohio
Marshall
Monongalia
Wetzel
Marion
Pleasants
Preston
Dodd- Harrison
ridge
Wood
Hampshire
Barbour
Tucker
Jackson
Roane
Grant
Hardy
Lewis
Cal- Gilmer
houn
Upshur
Randolph
Pendleton
Braxton
Putnam
Berkeley
Mineral
Taylor
Ritchie
Wirt
Mason
Morgan
Tyler
Webster
Clay
Cabell
Nicholas
Kanawha
Pocahontas
Wayne
Lincoln
Boone
Mingo
Fayette
Greenbrier
Logan
October, 2008
Raleigh
Wyoming
McDowell
Summers
Mercer
Monroe
Jefferson
Our Experiences
Case #1
Community Health Center
Quality Improvement Committee
Before assistance
 Complaint session, no solutions
 Meeting but non-productive
- 2006 QI Plan
 No clinical measures
 Activity oriented
Case #1
Community Health Center
Quality Improvement Committee
Intervention
 Reviewed summary report and
suggested project to clinic
 Participated in QI meetings
 Reviewed 2006 QI plan with committee
Case #1
Community Health Center
Quality Improvement Committee
After assistance
 Utilizing “Plan, Do, Study, Act”
- Number of A1cs per year
 CDEMS data
 Developed standing orders
- To implement July1, 2008
 Follow up review
 Developing 2008 QI Plan
- Identified need for on-going training
- Identified need for designated IT
person
Case #2
Community Health Center
Before assistance
 One nonclinical person using registry
info and reporting to administrator
 Most of clinic staff unaware of registry
benefits
 Clinical staff and nonclinical staff not
working together
Case #2
Community Health Center
Intervention
 Reviewed summary report and identified
clinic project
 Created PP presentation explaining our
work, the partners, and potential
benefits to the clinic
 Presented at general staff meeting
 Met with providers post staff meeting
Case #2
Community Health Center
After assistance
 Main registry person feels supported
 Most of staff aware of potential benefits
and engaged
- Asked for flow sheet to be put into
registry
- Asked for patient handouts to be revised
 Medical staff inviting us back
Number
Our Success Story:
Contacts
200
180
160
140
120
100
80
60
40
20
0
7/1/07 to
9/30/07
10/1/07 to
12/31/07
1/1/08 to
3/31/08
Time Period
4/1/08 to
6/30/08
7/1/08 to
9/30/08
Promoting Our
Success Story
Beyond Our State
 Poster at the American
Association of Diabetes Educators
conference, August 2008
 Associate Editor of On the Cutting
Edge of the American Dietetic
Association
In Summary
We are. . . .
Liaisons!!
Questions?