Elderly couple planning

Changing eating and exercise habits are common lifestyle recommendations for improving health and preventing disease. Too often a health crisis or unexpected chronic disease diagnosis turns these recommendations into medical necessities. Implementing an effective screen, test, refer process can prevent the onset of disease and improve health outcomes.

Denise Kolba, RN, program manager for Great Plains Quality Innovation NetworkMany individuals delayed routine care during the COVID-19 pandemic,” stated Denise Kolba, RN, program manager for the South Dakota Foundation for Medical Care. “In addition, the social isolation left many with extra weight due to decreased activity and increased consumption of unhealthy comfort foods.  These factors increase the risk for diabetes and make the screen, test, refer process even more important.”

Methods for screening range from risk tests completed in the waiting room to a full blood panel. Even lab results displaying normal ranges should be reviewed carefully. Additional testing can be scheduled when results are showing an upward trend for A1C or blood glucose levels.

Jordan Eichacker, Madison Regional Health SystemWith known elevated blood sugar levels, individuals have the opportunity to take control of their health with changes to nutrition, activity and behavior in order to prevent or delay the onset of Type 2 diabetes,” added Jordan Eichacker, MS, RDN, LN, dietitian and diabetes prevention program coordinator for Madison Regional Health System (MRHS).

With a full year of behavior change support, individuals have the chance to walk the path of disease prevention versus disease management. Over half of the 16 individuals in the MRHS DPP program achieved a weight loss of seven percent or more, an average of 20 pounds per participant. In addition, the group achieved an average of 177 minutes of weekly physical activity.

This successful behavior change resulted in decreased levels for blood pressure, cholesterol and triglycerides. Participants also reported increases in perceived energy and confidence, among other benefits

Identifying and diagnosing prediabetes through screening and testing often provides the incentive for behavior change.  Early diagnosis offers the luxury of time to adapt and the potential to prevent progression to diabetes. An official prediabetes diagnosis also impacts reimbursement for education and creates eligibility for evidence-based programs, such as the Diabetes Prevention Program.

  • At least 150 minutes a week of moderate intensity activity such as brisk walking
  • At least 2 days a week of activities that strengthen muscles
  • Adults over 65 should add activities to improve balance such as standing on one foot

“As a health system, we benefit from proximity to providers, as we all reside under one roof, and it’s their support of the program to which we owe the credit. Their support feeds our referral process which then fuels our passion to deliver a successful program,” shared Eichacker. “We do, however, recognize our referral process is not a complete representation of our community. In the future, we hope to identify other avenues to reach those in the community who may not utilize MRHS for medical care.”

Eichacker will share more insights on the success of the MRHS program in the upcoming Best Practice Brief: Champions for Diabetes Prevention scheduled for March 18, 2021 at 11:00 AM CT. This webinar brief is the first of three hosted by the South Dakota Foundation for Medical Care in partnership with the Great Plains Quality Innovation Network to highlight effective screen, test and refer processes.

Best Practice Briefs are 20-minute webinars highlighting successful system and policy change. This series is hosted by the South Dakota Foundation for Medical Care in partnership with the Great Plains QIN.

Champions for Diabetes Prevention March 18 at 11:00 AM
A provider recommendation is the number one reason individuals enroll in lifestyle change programs. Madison Regional Health System boasts a Diabetes Prevention Program certified by the Centers for Disease Control and Prevention (CDC). Jordan Eichacker, MS, RDN, LN, dietitian and diabetes prevention program coordinator, will provide an overview of their effective screen, test, refer process and share additional insights on the impact of provider champions leading the charge to prevent diabetes.
Monument’s Epic Chronic Disease Referrals March 25 at 12:00 PM CT 
Having recognized chronic disease management as a healthcare priority, Monument Health actively engaged in leading and promoting Better Choices, Better Health (BCBH) workshops. Implementing the referral process into Epic transferred the steps for assessment, registration, and attendance to qualified BCBH staff. With BCBH Master Fellow credentials and system-wide disease management perspective, Shelly Roy, DNP, MHA, BSN, is well-positioned to effectively integrate referrals on a large scale.
Connecting Life Events to Lifestyle Change  April 1 at 12:00 PM CT
Most people experience at least one moment in life when they are inspired or motivated to make a change. Recognizing opportunities to offer additional education, resources and tools can reinforce and encourage change. Utilizing chronic disease self-management education programs provides guidance beyond the exam room. Denise Kolba, RN, South Dakota Foundation for Medical Care program manager serves as a Better Choice, Better Health Master Trainer and has led many participants on a journey to self-management and improved quality of life. 

Source: Q Insider | March 2021