Patients with diabetes have a higher risk for adverse outcomes, including blindness, peripheral neuropathy, amputations and early death. Engaging diabetic patients in their care and helping them manage their disease promotes overall wellness and reduces cost of care. NEMG has launched a task force to develop a comprehensive diabetes quality care clinical pathway. Led by Robert McLean, MD, NEMG medical director, clinical quality, and Carrie Guttman, MSN, RN, NEMG nursing lead and quality manager, the multidisciplinary team is composed of physicians, APCs, RNs, care coordinators, a clinical pharmacist, a certified diabetes educator and a preventive health coordinator.
Throughout phase one of the project, Judy Peterson-Picket, RN, clinical integration consultant, will conduct system-wide listening sessions to map current care processes. Preliminary steps include piloting the proposed pathway using a team-based model and focusing on patients with HgB A1c > 9. The goal is to eliminate barriers to high-quality care by improving processes and using many members of the healthcare team. To improve patient engagement NEMG must develop personalized care plans, by identifying barriers and social factors, providing adequate education with shared decision-making and coordinating care for complex patients.
