Good habits are hard to form and bad habits are hard to break. Even with a strong motive, basic lifestyle changes are a challenge for most people. Individuals newly diagnosed with diabetes face the added layer of monitoring blood sugar levels and/or managing medication. Those using insulin are also at risk for adverse drug events and must be carefully managed by their entire healthcare team.
The Rapid City Regional Health Family Medicine Residency (FMR) program is working to adjust the personal care plan for diabetic patients to reduce adverse drug events and improve overall health outcomes. Quality improvement efforts include tracking and evaluating key diabetes care elements including foot exams, eye exams, A1C levels, lab levels and diabetic agent modifications, including dosage or usage.
Kathy Jedlicka, RN, patient care coordinator for the FMR, explained, “We want to make a difference in our patients’ lives. We have set up new parameters with the residency program and our patients so we are not just reporting numbers, but focusing on the outcomes.”
The American Diabetes Association provides a variety of tools and resources for all individuals managing diabetes including a special section for those recently diagnosed. Healthcare providers can offer referrals to approved self-management education programs and recommend additional healthcare team members, such as a dietitian and diabetes educator.
“I really stress to a patient that they control diabetes, diabetes will not control them. Together, we figure out what medications are the best fit based on their blood sugars, lifestyle and what they can afford,” explained Linda Bartl, RD, LN, CDE, diabetes educator at Sanford Aberdeen Medical Center. “I also tell them my husband is diagnosed with diabetes and my cupboards don’t look any differently than theirs. I will show them how to fit in any food.”
Pharmacists are another valuable member of the healthcare team. South Dakota State University’s School of Pharmacy and Allied Health Services Dean Jane Mort, Pharm D, gave the following advice, “When getting a prescription and something unexpected or unpleasant happens, don’t forget to let your pharmacist know. Your pharmacist is well prepared to help you address this problem in an effective way, from contacting your doctor for a medication change to providing good advice on management techniques.”
Great Plains Quality Innovation Network (QIN) has been supporting healthcare and community organizations across the region to promote diabetes self-management and improve medication safety in addition to other initiatives. Program Manager Linda Penisten, RNC, OTR/L, [pictured] shared, “Preventing adverse drug events of high risk medications, especially of newly diagnosed patients, is important to me because the outcomes can be detrimental to patients and families. It can be overwhelming, but does not have to be with the right resources.”
Healthcare professionals can also use the resources from the Institute for Healthcare Improvement (IHI) which highlight the six areas of the Chronic Care Model to encourage high-quality chronic disease management.
- Self-Management Support
- Delivery System Design
- Decision Support
- Clinical Information Systems
- Organization of Health Care
Penisten added, “These Chronic Care Model core elements are important to allow for patient activation. We all learn differently and having exposure to a variety of resources can optimize the treatment outcomes while increasing patient involvement.”