Jeanie Schmidt Free Clinic Herndon, VA

1. Jeanie Schmidt Free ClinicHerndon, VA Kathy Gold, RN, MSN, CDE

2. SWOT STRENGTH WEAKNESS OPPORTUNITY THREAT

3. Patient Strengths • Empower patients, not as isolated, encourages sharing feelings and frustrations • Information learned in class moving beyond patient to family and friends • Information shared by patients that may not have been shared with HCP during typical visit • Dig deeper into patient’s feelings • Learned goal setting • Built a trusting environment • Breaks down ethnic barriers • Decrease wait time • Group support • Increased motivation

4. Staff Strengths • Support of clinical staff and administration • Everyone on the same page • New skill development • Motivating to staff • Something new • Attracted new staff • Increase availability

5. Clinic Strengths • Accommodate more patients • Save physician time for complex patients • Frees up time for more acute patients and high risk patients to be seen by other providers • HCP able to follow patient more closely • Build a relationship with patient • Group visits accommodate lower risk patients that will benefit from intervention but condition may not warrant extra attention

6. Clinic Weakness • Organization may be thinking too small or don’t share expanded vision • Don’t see growth • Cost • Resource intensive • Space required • Requires a 2 hour block of time • Sustainability - volunteer nature of team

7. Patient Weakness • Language barrier • Not appropriate for all patients • Hypertension and diabetes in one group • New terminology – goal setting • Cultural competence • Time offered, not available at night or weekend • What is “life after group visit?” • Culture • Gender • Recruitment understand what visits means

8. Staff Weakness • Resistance from some staff members • May not be something all staff can do • No NP’s to engage in process • Don’t like change • May require training • Not part of job description

9. Staff Opportunities • Two new MD’s • Identified successful training programs – certificate for promotoro or health educator • Engage staff • Share education among experts – pharmacist, CDE, podiatrist, dietitian • Develop job description for group visit providers

10. Patient Opportunities • Develop phase 2 – • Diabetes group visit • Hypertension group visit • Consider drop in group visits • Develop curriculum • Develop advanced curriculum • Created group education class for complex patients • Enroll more patients • Divide groups into cultural groups • Need entry and exit criteria • Spread visits from monthly to every 3 months

11. Staff Threats • Afraid to move out of comfort level • No back-up in case of emergency • HCP may be forced to participate • May not be in favor of concept • Change • Continuity • Sustainability • Lack time • Training of staff • Transition

12. Patient Threats • Recruitment • Patient identification • Entry and exit criteria • Too sick for group visit • Transition • Primary care to group visit • Group visit to primary care

13. Questions? Kathy Gold, RN, MSN, CDE Diabetes Research and Wellness Foundation 800-941-4635 kathy@kathygoldcde.org Virginia Diabetes Council Virginia Diabetes Plan 2008-2017 www.virginiadiabetes.org