Healthcare Team Perception, Are We Beating Diabetes?

Background: Diabetes (DM) is a costly disease that negatively impacts patients and the healthcare system that requires complex and structured management. Literature has shown a gap in effective, structured diabetic education and management for providers and patients. Objective: The purpose of this quality improvement project was to investigate the impact of how outreach, through a structured educational care plan, affects healthcare team experience, perception, and impact on their ability to communicate and comanage patients' chronic diabetes. Utilizing telemedicine as an alternative to the office visit healthcare model to address a gap in care by providing ongoing, structured diabetes education and management. Methods: A small-scale study initially included ten participants, with five that completed the study. This included the Population Outreach Team (POT), one provider, and four auxiliary support staff. They were introduced to and utilized a care plan tool (CPT) to assist providers and auxiliary health team communication and education delivery to patients with DM. The theoretical and implementation framework that guided the study was based on the nudge theory, focused on altering habits and behavior, and the Model for Improvement supporting future alterations and improvement as identified. A CPT was designed based on HEDIS diabetes measures and the American Diabetic Association (ADA). Improvement was measured through nine question pre- and post-surveys with an additional four questions specific to the CPT use based on a modified RAND Likert scale patient satisfaction survey. A post-qualitative interview with the provider was conducted to gain further insight into CPT use and perception. Results: A total of ten healthcare and auxiliary participants joined the study; of these, five completed it. The data, including the pre- and post-perception surveys, were collected over a 6-week study period with a post-implementation interview with one provider. Data analysis was captured through descriptive statistics. Pre-perception, M = 19.6 (SD. 4.04, 14 – 25). Post-perception, M = 7.60 (SD. 1.34, 6 – 9). CPT perception post, M = 14.4 (SD. 3.65, 10 – 18). A lower score indicated improvement. The interview identified the following barriers that impacted the CPT's success, including the patient-provider relationship, EHR "easability", patient readiness, and patient education barriers. Conclusion: This small study indicated the positive impact structured, ongoing education provides to improve communication and comanage patients' with DM through the POT improved perception with CPT use. Barriers identified will assist with future implementations and other areas for improvement, which may increase success in the objective of this study and the delivery of healthcare for patients with DM. Future utilization of this intervention may be easily translated to other primary care environments. The intention is that successful DM management may lead to decreased medical management, complications, and financial strain.