JDRF Juvenile Diabetes Resaerch Foundation Usually striking before the age of 30, juvenile diabetes takes a harsh toll on people. …
Reporting Template for Diabetes Prevention Pilot
December, 2002
Center Name: Hill Health Center Date: 01/08/2003
|Aim: |Place an X in the next box if your Aim Statement has changed| |
| |in the last month | |
The system of care will be redesigned by implementing the Care Model so
that organizational identification and intervention can be implemented,
with the following goals: 1 identifying individuals at risk for the
development of diabetes, and 2 achieving and sustaining a 7 weight loss
and an increase in physical activity of 150 minutes/week for example, 30
minutes/day, 5 days/week
|Population of |Place an X in the next box if your Aim Statement has | |
|Focus |changed in the last month | |
All adult and mature adolescent Hill Health Center users at risk for
developing diabetes ie, hx GDM, first degree relative of diabetic, and
fasting glucose 110 - 125 or random blood glucose 126
Key Recommended Measures:
|Measures |Target |
|
|level |
| of patients with current self-management goal setting 12 |70 |
|months | |
| of patients with FBS done twice in last 12 months at least 3 |67 |
|months apart | |
| of patients with HbA1c done twice in last 12 months at least 3|90 |
|months apart | |
| of Patients with weight recorded at last visit |90 |
|Average weight loss |7 |
| of patients reporting at last visit at least 150 minutes of |60 |
|exercise per week | |
| of patients with HbA1c 70 OR with Fasting glucose 125 mg/dl|1 |
Description of Tests of Changes
|Component|List all Tests of Change: Please document sources that helped to |
| |generate these ideas for change key concept grid, lecture, article,|
| |another health center, etc |
|Community|Test our DCPs continued support for
Diabetes Prevention Activities |
| |by asking them to provide a pre-diabetes in-service training for our|
| |Internal Medicine Providers Cindy Kosac, our DCP Contact, |
| |presented a informative PowerPoint presentation to internal medicine|
| |providers The presentation increased awareness regarding |
| |pre-diabetes as it related to the DPP results There was good |
| |Provider turnout |
|Self | |
|Managemen| |
|t | |
|Delivery |Our plan to test the high risk screening tool over a longer period |
|System |of time PDSA Cycle 2 was not completed during the period of time |
|Design |planned secondary holidays We will repeat this test after the |
| |holidays |
|Organizat|To once again test the extent to which senior leadership and other |
|ion of |team members are committed to
accomplishing project activities |
|Healthcar|Results of this test indicate that Diabetes Prevention Team members |
|e |were allowed and committed to attending weekly meetings and that |
| |there will be a strong representation during Learning Session 2 |
| |These results indicate continued support from Senior Leadership and |
| |a commitment from team members |
|Decision |To test whether pedometers were easy to use, accurate and motivate |
|support |people to increase physical activity based on lecture This test |
| |indicated that pedometers increased physical activity It is |
| |important to emphasize the importance of consistently using |
| |pedometers during the same intervals each day in order to obtain |
| |accurate and reliable results |
|Clinical |Identify and characterize the population at risk based on |
|informati|established criteria by testing our ability to perform queries of |
|on |our information system for patients with a history of Gestational |
|systems |Diabetes This test
showed that queries can be run quickly for |
| |specific populations based on IDC-9 codes ie, IDC-9 Code for |
| |gestational diabetes is 2488 We will be training providers to |
| |correctly and consistently use the IDC-9 Code for pre-diabetes or |
| |impaired glucose tolerance ie, 2713 so that they can be |
| |imported in PECS |
List of Changes Implemented
List, by component of the Chronic Care Model, changes tested that have been
adopted permanently These changes are now part of the clinic routine A
one-sentence description is all that is needed
|Component |Changes Implemented Adopted permanently by the organization |
|Community | |
|Organizati| |
|on of | |
|healthcare| |
|Self-manag| |
|ement |
|
|Delivery | |
|system | |
|design | |
|Decision |We are having weekly diabetes prevention meetings that serve to |
|support |collectively accomplish project activities We will continue to |
| |send no less than 4 team members to each Learning Session |
| |Pedometers will be used during our healthy lifestyle intervention |
|Clinical | |
|informatio| |
|n systems | |
Partnerships:
No new partnerships have been established yet
Summary of Results:
While we have been able to identifying high risks through a variety of
methods ie, database queries and screening tool use ,it is essential
that a system be in place to effectively track yields and other important
measures We feel confident that providers
will correctly and consistently
use the IDC-9 code 2713 so we can electronically import our population of
interest in PECS eliminating the need for burdensome manual tracking
procedures Our organization remains committed to seeing this program
succeed and we feel confident that we will have a positive impact on the
lives of our target population
Also, please explain the reason for any changes in your aim statement or
your population of focus definition
Self-Assessment:
Utilize the definitions provided in the 1-5 assessment scale on the virtual
office to rate your team
Source:vba.va.gov
