UP Network Webinar. Everyone with Diabetes Counts: HHQI Underserved Population Network Call. Underserved Population (UP) Network Webinar

Transcription

1 Underserved Population (UP) Network Webinar presented by Home Health Quality Improvement (HHQI) National Campaign UP Network Webinar Everyone with Diabetes Counts: The Impact on Rural Southern West Virginia Guest Speaker: Natalie Tappe, RN, MSN EDC Lead Project Coordinator WVMI & Quality Insights Everyone with Diabetes Counts: HHQI Underserved Population Network Call Natalie Tappe, RN, MSN 1

2 Presentation Objectives Overview of the program Implementation and evaluation of the program Lessons learned with self management, patient engagement, rural issues, etc. Home Health collaboration Overview Everyone with Diabetes Counts (EDC) WVMI was awarded a Special Innovation Project sponsored by the Centers for Medicare & Medicaid Services (CMS). Everyone with Diabetes Counts (EDC) is providing in depth diabetes education to thousands of Medicare recipients with diabetes in Southern West Virginia. WVMI is providing Diabetes Self Management Education (DSME) classes to teach diabetic patients why they should, and how they can manage their diabetes for a healthier life. WVMI is providing data and assistance to health care providers seeking to become Diabetes Centers. Two other states are also participating in this program: New York (Hispanic population) and Texas (African American population) 2

3 Targeted Counties (22) Why West Virginia? Approximately 229,379 people in West Virginia have diabetes. Over 62,162 are undiagnosed. (1) Year after year, WV is ranked among the top states with the highest prevalence of diabetes as well as obesity, MI and stroke. Rates in Southern WV are approaching 16 percent of the population. Why West Virginia? Less than half of West Virginians with diabetes have had any education about the disease. Access to any type of diabetes education or selfmanagement class is limited or non existent in most rural counties. 3

4 Chart Diabetes Prevalence in WV American Diabetes Association Releases New Research Estimating Annual Cost of Diabetes The American Diabetes Association (ADA) estimates that total costs of diagnosed diabetes have risen to $245 billion in 2012 from $174 billion in 2007, when the cost was last examined. This represents a 41 percent increase over a five year period. Most of the cost for diabetes care in the U.S. (62.4 percent) is provided by government insurance (Medicare, Medicaid). The rest is paid by private insurance (34.4 percent) or by the uninsured (3.2 percent). 4

5 ADA Recognition EDC has received recognition as a "promising practice" from the ADA The ADA defines a promising practice as: Practices that can be applied to community efforts aimed at reducing the risk of type 2 diabetes and obesity in high risk populations, including youth and adults. What is Diabetes Empowerment Education? Diabetes Education Empowerment Program (DEEP) Developed by The Midwest Latino Health Research Training and Policy Center at the University of Illinois at Chicago Created to increase the capacity of participants to plan and implement diabetes training programs that train community health workers or health promoters to become effective diabetes educators and outreach workers 5

6 DEEP Curriculum Focuses on the prevention and control of diabetes through 8 learning modules (understanding the human body, diabetes and risk factors, physical activity, meal planning, exercise, and stress management) Training is designed to enhance clinician patient communication skills and aides in decision making Based on empowerment theory principles of health care Participatory techniques Delivered by community health promoters and peer educators Taught on a 6 th grade level with low literacy materials used to assist in teaching Tools of the Trade Diabetes and Our Body 6

7 Good Food vs. Bad Food Diabetes and Complications Kidney Function and Heart Disease 7

8 DEEP in the Community Attaining our goal of engaging 6,000 Medicare beneficiaries to participate in the DSME classes requires a multifaceted approach to training, recruiting, collaborating, etc. We utilize the community/services in targeted counties by contacting: Agencies on Aging, FQHCs, state associations, existing health based coalitions, providers, faith based organizations, home health agencies, etc. How DEEP Works WVMI is collaborating with state and local advocacy groups, organizations and councils to implement activities to decrease health disparities in the targeted counties. WVMI is also collaborating with existing coalitions or diabetes education programs to ensure there is no duplication of services. WVMI is providing participants with educational materials to continue DSME. Data Collection and Analysis A pre and post test is administered to evaluate the effect of the program on A1c, blood pressure, weight and lipids for participants. Data is collected at baseline (prior to the EDC classes) at 3 months and 6 months after class completion on 250 of the 2500 participants taking the pre and posttest. 8

9 Outreach Materials Community Outreach Outreach Tools 9

10 EDC Cookbook Pamphlets Barriers and Lessons Learned 10

11 Barriers Fatalistic attitude (i.e. My family has the sugar so it s only a matter of time. ) Anger (Too old for change i.e. I have been eating this way for 80 years. You re not going to tell me what I can and cannot eat now. ) Religious reasons Access to affordable nutritious food Mountainous terrain with nurses sometimes traveling over 2 hours to teach classes Barriers No public transportation available in the most rural areas Weather (especially this winter) Access to quality Health Care Lack of support from the Medical Community Community support minimal Community Health Workers not compensated Lessons Learned Always assess your audience Utilize low literacy materials, if needed Engage participants/encourage participation when teaching by utilizing: Demonstrations, Games, Role Play, Flip Charts, Models, Handouts, Repetition Prepare for questions There are many patients that have never experienced DSME Persistence pays off 11

12 Lessons Learned Effective advertising Direct to Beneficiary mailings (most successful), Posters, Flyers, Radio, TV, Newspaper, Web, Word of Mouth, Direct Mail Campaigns Do not have class on the 1st or 3rd of the month. Do not have class on Wednesday nights. Preparing food from a food bank Churches are hard to access unless you have a close contact Home Health Collaboration How can you help? You can attend a Train the Trainer course and become a licensed Community Health Worker that teaches DSME. Encourage family, friends and caregivers to participate in DSME. Utilize outreach materials to promote participation in local DSME classes. 12

13 How Can You Help? Promote and sustain DSME throughout your communities by: Referring those newly diagnosed and those just needing a refresher Encouraging physicians to also refer diabetic patients to DSME classes Holding classes within the home health community, if graduated from a recognized program Provide space for DSME classes at your facilities, if possible. How Do We Sustain DSME? Sustainability Continuing partnerships within the communities: Agencies on Aging, FQHCs, state associations, existing health based coalitions, providers, faith based organizations, home health agencies, family resource networks, etc. Training Community Health Workers in an evidence based DSME program Training people who are already part of the communities where we work and live Lay people, pharmacists, students, dieticians, RNs, LPNs, Mas, etc. Establishing and promoting diabetes coalitions Promotion of EDC classes using a local celebrity 13

14 A Winning Story.. Credit: Diabetes Health, January 2008 Project Information Schedule of classes posted Toll Free Hotline Number: Contact Us Lead Project Coordinator Natalie Tappe ext Communications Mitzi Vince ext Scheduling & class information Mary Dayhaw ext

15 End References Stohr, A. Diabetes and Health Equity in West Virginia: A Review. HSC Statistical Brief No : Geiss LS, Cowie CC. Type 2 diabetes and persons at high risk of diabetes. In: Narayan KM, Williams D, Gregg EW, Cowie CC, eds. Diabetes and Public Health: From Data to Policy. New York, NY: Oxford University Press; 2011: American Diabetes Newsletter, March 6 th, 2013 This material was prepared by the West Virginia Medical Institute, the Medicare Quality Improvement Organization for West Virginia, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication No. 10SOW WV EDC MV App 4/14 HHQI Resources Disease Management: Diabetes (Focused) Best Practice Intervention Package (BPIP) Cardiovascular Health and Diabetes Clinical Evidence Based Practices for Diabetes Diabetic Medication Reference for Clinicians Diabetes Risk Assessment & Prevention My Diabetic Education Workbook Controlling My Diabetes: I Know, I Can, I Will Stoplight Tool: Controlling Diabetes at Home 15

16 HHQI Resources HHQI Resources Next UP Network Event Using Occupational Therapy to Optimize Outcomes April 23 at 3 4 pm (ET) Carol Siebert, MS, OTR/L, FAOTA Principal, The Home Remedy, Occupational Therapy Practice Karen Vance, OTR/L Supervising Consultant, BDK Health Care Group Register now at: 16

17 The Gravity of Falls: Evidence-Based Preventative Strategies Tuesday, April 29, 2014 at 2 3 pm (ET) Topics Discuss validated multifactorial fall risk assessments Examine your data findings and adjust your internal thresholds to identify high risk patients in need of interventions Identify fall prevention interventions for implementation by clinicians in the home Discuss major classes of medications that either increase risk for falls or increase risk of injury from a fall Review changes in metabolism of medications commensurate with aging Speakers Nancy Kimmons, BS, PT, Home Care Therapy Operations Manager, Rehab Affiliates, Division of Main Line Health, Philadelphia, PA Michele James, BSN, MSS, RN BC, Home Care Case Manager, The Home Care Network, Jefferson University Hospitals, Philadelphia, PA Chuck Lally, RPh, Pharmacist, University Hospitals Home Care Services, Cleveland, OH Joanne M. Wile Avenmarg, OTR/L, M.S., Director of Clinical Operations, University Hospitals Home Care Services, Cleveland OH Connect with HHQI Facebook Twitter LinkedIn MyHHQI Blog Discussion Forum under Network tab on HHQI website LiveChats under Network tab on HHQI website THANK YOU! This material was prepared by the West Virginia Medical Institute, the Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication Number: 10SOW WV HH MMD Approved 4/