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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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EP16a, UC Irvine Diabetes Program.pdf
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UCI Diabetes Program
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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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UCI Diabetes Vision
Senior Center
Fellows Clinic
Orange Primary
Care
Joslin
Plaza Primary
Care
Inpatient
Santa Ana
Anaheim
UCI Diabetes Program
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EP16a, UC Irvine Diabetes Program.pdf
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Senior Center
Orange Primary
Care
Inpatient
Joslin
Fellows Clinic
Anaheim Santa Ana
Plaza Primary
Care
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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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House of Pillars
UCI Diabetes Program
In P
ati
en
t
Pla
za
Pri
mar
y C
are
and
M
ult
i Sp
ecia
lty
Ora
ng
e
IM, S
HC
, M
ult
i Sp
ecia
lty,
Man
ches
ter
OB
, Oth
er
FQ
HC
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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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Tools for Success
• Outpatient Flow Chart
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EP16a, UC Irvine Diabetes Program.pdf
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Inpatient Discharge Education
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EP16a, UC Irvine Diabetes Program.pdf
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Other Education Materials
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EP16a, UC Irvine Diabetes Program.pdf
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Education Record • * if approved
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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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Follow Up Phone calls
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EP16a, UC Irvine Diabetes Program.pdf
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EP16a, UC Irvine Diabetes Program.pdf
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Quality Initiatives
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EP16a, UC Irvine Diabetes Program.pdf
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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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EP16a, UC Irvine Diabetes Program.pdf
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Resources? Guidelines?
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EP16a, UC Irvine Diabetes Program.pdf
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