uci diabetes program - uc irvine health · ep16a, uc irvine diabetes program.pdf 8. diabetes...

UCI Diabetes Program

In transition

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EP16a, UC Irvine Diabetes Program.pdf

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Diabetes Statistics • Diabetes Prevalence (2011 data): 25.8 million children and adults in the

U.S.

• Cost of Diabetes (2007 data) Total cost: $174 billion – Direct medical costs: $116 billion

– Indirect costs (loss of productivity, etc): $58 billion

• Cost of diabetes in Orange County by Congressional district serving zip code 92868 – District 47:$395,300,000

– District 40: $439,000,000

– District 48: $420,800,000

– Total: $1.255 billion

• Uncontrolled diabetes is: – The leading cause of kidney failure, non-traumatic lower-limb amputations and

blindness among adults in the U.S.

– The major cause of heart disease and stroke in adults in the U.S.

• Pre-diabetes Prevalence (2011 data) – 35% of U.S. adults aged 20 years or older have pre-diabetes

– 50% of U.S. adults aged 65 or older have pre-diabetes

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Previous State

“Disjointed”

“Silos”

“Not Coordinated”

“5 different programs”

“Inconsistent Resources”

“Not all accredited”

“I don’t know all of the sites where we provide diabetes

care”

“The inpatient program

is separate from the

outpatient programs”

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UCI Diabetes Locations

Senior Center

Fellows Clinic

Orange Primary

Care

Joslin Plaza

Primary Care

Inpatient

Santa Ana

Anaheim

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UCI Diabetes Vision

Senior Center

Fellows Clinic

Orange Primary

Care

Joslin

Plaza Primary

Care

Inpatient

Santa Ana

Anaheim


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5

Senior Center

Orange Primary

Care

Inpatient

Joslin

Fellows Clinic

Anaheim Santa Ana

Plaza Primary

Care

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Multi-Disciplinary Team

• Patient • Medical Director • Practice Manager • DM educator • Dietitian • Pharmacist • Community Health Worker • Authorization Coordinator • Research

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Vision and Mission Statement

• Mission – To provide high quality diabetes care in a manner that

supports the clinical, education and research programs of the School of Medicine and UCI Medical Center, and to meet the highest standards of care and certification by healthcare agencies

• Vision – The Inpatient and Outpatient Diabetes Summit committee

will develop diabetes care policies to support the missions of UCI Medical Center and the School of Medicine by establishing, implementing and analyzing standards of care for inpatient and outpatient diabetes management to improve care quality and outcomes.

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Diabetes Program Goals

• Standardize delivery of care in accordance with published clinical guidelines and/or evidence-based practice.

• Provide patient education, monitoring and communication to enhance the patient’s self management and adherence to the prescribed treatment plan.

• Continuous collection of performance measures to guide the improvement of processes which provide quality health care that meets or exceeds expectations.

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House of Pillars


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Diabetes Steering Committee

UCI Diabetes Coordinator and Medical Director

Specialty Services

Pharmacy

Referral Center

Marketing / Business Development

Billing

Call Center

IT

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Patient-Centered Model

Patient

Family

Friends

Spiritual

Endocrin- ologiests

ED Nutrition

Pharmacy

Pharmacy

Nutrition

Social Worker

UC Irvine Healthcare

Diabetes Program

Medical Director

Program Manager

Research

Spiritual

Community Coach

Diabetes Educator

Information Services

Perform- ance

Improve- ment

Case Mgmt

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Steps Taken

• Standardize – Policy and procedures – Flow sheets – Paneling methodology

• Meeting with IT for patient data • Paneling Patients to a single Primary Care doctor • Using lab data

– Coordinating with an outside vendor to collect as much available lab data as possible

• Push data to improvement teams

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Coaching Levels

• Level 1 – Non-Healthcare Professional – 4 volunteers at 2-3 sites

• Level 2 – Healthcare Professional Non-Diabetes

Educator – Clinic MAs

• Level 3 – Non-Credentialed Diabetes Educator – Clinic RNs

• Level 4 – Credentialed Diabetes Educator – Terrye Peterson, RN, CDE @ Orange – New Hire @ Plaza

• Level 5 – Advanced Level Diabetes

Educator/Clinical Manager (non-Rx with protocols or Rx)

– Mary Jean Christian, RD, CDE

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Tools for Success

• Outpatient Flow Chart

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Inpatient Discharge Education

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Other Education Materials

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Education Record • * if approved

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Outpatient Education

• Group Appointments

– Diabetes Overview

– Diabetes Self Management Series (3-class series)

– Diabetes Diet

• Individual Appointments

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Follow Up Phone calls

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Quality Initiatives

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Recognition

• American Diabetes Association Recognition (2011-2015)

– Plaza Diabetes Clinic

– Orange Diabetes Clinic

• NCQA Recognized for clinical care (2010-2012)

– Plaza Endocrinologists (Wang, Choi & Elias)

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Resources? Guidelines?

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