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Improving Diabetes Outcomes by an Innovative Group Visit Model

Improving Diabetes Outcomes by an Innovative Group Visit Model. Background. Group Visits incorporate elements of both a group educational visit PLUS an individual office visit 1 Group Visits are one of the ten features of the establishment of a medical home said to impact outcomes the most 1

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Improving Diabetes Outcomes by an Innovative Group Visit Model

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  1. Improving Diabetes Outcomes by an Innovative Group Visit Model

  2. Background • Group Visits incorporate elements of both a group educational visit PLUS an individual office visit1 • Group Visits are one of the ten features of the establishment of a medical home said to impact outcomes the most1 • Published studies on Group Visits currently show inconsistent clinical outcomes1 • Most studies to date have been done in large university, veterans clinics or health maintenance organizations1 • There is no established model for group visits, only general guidelines, making implication of this difficult in private practice1

  3. Research Question • Can an innovative approach to group visits improve the clinical outcomes of patients with diabetes?

  4. Methods • Records were reviewed to identify patients with A1C values of 7.5 or above (118/900 patients) • A focus group of 8 patients was done to identify interest and topics for group visit • A series of 3 group visits were done on a monthly basis with 22 patients divided into 3 separate groups • The group visit lasted 2 hours and was facilitated by the researcher using a curriculum she developed for the interactive white board (SMART Board)

  5. Methods • The first hour was spent on interactive focused education and the second hour individual assessments/medical management done while the group still discussed and viewed additional educational material with the M.A. in attendance on the SMART Board • Visit one focused on healthy eating & understanding diabetes, visit 2 on exercise, medication & monitoring, • visit 3 on coping and complications. • All participants had pre and post testing of A1C, LDL, Weight, BP, Beck Depression Index and the Seattle Outpatient Satisfaction Questionnaire

  6. Sample EMR History Screen

  7. Sample Physical Exam Charting For EMR

  8. Sample Characteristics • The eligible patients were invited by a mailing, a notice in the office, phone calls & personal invitation by their physician or NP to join the group visits • The first 30 patients that agreed and signed consent form were included in the pilot program and divided into 3 groups • When the visits began there was 22/30 that actually participated

  9. Sample Characteristics Gender Race AGE Years with D.M.

  10. Clinical Results Higher scores on the SOSQ = more satisfaction

  11. Results of evaluations Please rate each of the following aspects of the Diabetes Group Appointment n=22

  12. Results of evaluations How would you rate the facilitator in the following areas? N=22

  13. Evaluation • 20/22 (91%) said they would like to continue group visits • 13/22 (61%) said they would like to continue monthly meetings • 20/22 (91 %) participated in 3/3 (all) sessions • 2/22 (9 %) participated in 2/3 sessions • Having 3 groups running helped attendance as some would go to a different group

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