Health Improvement Consultants: A Unique Clinical Resource in West Virginia

1. Health Improvement Consultants: A Unique Clinical Resource in West Virginia Trisha Petitte, RN, BSN, MPA Marie Gravely, MA, RD, LD, CDE Nell Stuart, MS, RD, LD, CDE Translating the Science into Useable Tools

2. 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.

3. Strategies for Improving Patient CareDiabetes 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

4. Our Focus • Health Care Improvement • Professional Development • Community Intervention

5. 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

6. 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

7. 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

8. 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

9. The Picture As We Got Started Hancock Brooke Ohio Marshall Monongalia Wetzel Marion Morgan Pleas- Berkeley Tyler ants Preston Jeff- Mineral Taylor erson Dodd- Harrison Hampshire ridge Barbour Wood Ritchie Grant Tucker Hardy Wirt Lewis Cal- Gilmer houn Jackson Upshur Randolph Mason Roane Braxton Pendleton Putnam Webster Clay Cabell Kanawha Pocahontas Nicholas Wayne Lincoln Fayette Boone Greenbrier Logan Logan Mingo Raleigh Sum- September, 2007 Wyoming mers Monroe Mercer McDowell

10. The Picture Now Hancock Brooke Ohio Marshall Monongalia Wetzel Marion Morgan Pleas- Berkeley Tyler ants Preston Jeff- Mineral Taylor erson Dodd- Harrison Hampshire ridge Barbour Wood Ritchie Grant Tucker Hardy Wirt Lewis Cal- Gilmer houn Jackson Upshur Randolph Mason Roane Pendleton Braxton Putnam Webster Clay Cabell Nicholas Kanawha Pocahontas Wayne Lincoln Fayette Boone Greenbrier Logan Mingo October, 2008 Raleigh Sum- Wyoming mers Monroe Mercer McDowell

11. Our Experiences

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Our Success Story: Contacts

19. 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

20. In Summary We are. . . . Liaisons!!

21. Questions?