Focus on Quality Webinar July 2018 Indiana Quality Improvement Network

1. Focus on Quality Webinar July 2018Indiana Quality Improvement Network Maureen Moynihan, PharmD Clinical Pharmacist Phone: 219-872-6200 ext.: 3777 Email: mmoynihan@healthlincchc.org

2. Indiana State Department of Health Primary Care Learning Collaborative • Provider Team: • Nurse Practitioner • Registered Nurse • Clinical Pharmacist • Certified Medical Assistant • One focus: ↓ # of uncontrolled patients with diabetes on provider panel

3. DIABETES A1C CONTROL v • DIABETES A1C POOR CONTROL: *a lower percentage is better* • Baseline: 37% • Goal: 20% • Current: 18.5% • (as of 06/12/18)

4. v SUCCESSFUL PDSA • Diabetes A1C Deficiency Call List: • Plan: A deficient patient call list was generated. The provider team called those patients and scheduled appointments for them to come and address their gaps in care; they also flagged patients who were already scheduled for appointments, to discuss missing measures with them at the time of their visit. • Do: Ran the test on a month-to-month basis. • Diabetes: Aug 2017: 33.5%, September 2017: 28.7% • Study: Provider team decided to continue with the call list as it notifies healthcare team and patient to the screening gap. Also the use of a pharmacy student to scrub the list and make the phone calls in order to maximize provider time. • Act: Scrub the list quarterly for best use of time.

5. USEFUL RESOURCES • Clinical Pharmacist Insulin Titration Follow-up Call List • Insulin-treated patients with uncontrolled diabetes are followed up within 1-2 weeks period via phone to adjust insulin doses based on a collaborative practice agreement.

6. USEFUL RESOURCES • Diabetes Self-Management Education • All Provider Team Members Involved • Set Class Curriculum: • Meals • Monitoring • Movement • Medications • Long-term Complications • Standards of Care • Support System

7. USEFUL RESOURCES • Opportunity to learn from providers and other patients • Less time constraints than provider appointments to give comprehensive education on diabetes self-management • Allows provider team to assess patient confidence in self-management skills • Gives provider team the opportunity to identify and remedy deficiencies in diabetes patient education • Gives a setting for patient to set self-management goals with check-ins at future classes

8. TAKE HOME TIPS • Follow-up is KEY! • Teamwork is KEY! • Patient Education is KEY!