Better Health for Diabetics

In the seven months since we launched GBMC’s new vision and strategic plan (“To every patient, every time, we will provide the care that we would want for our own loved ones”), (See: "GBMC HealthCare System – Our New Vision, Our New Plan to Get There") we’ve taken a number of steps in the right direction.

Last week, I talked about the evidence of us improving the patient experience of care (Better Care). This week, I want to highlight an initiative designed to improve the health outcomes of a group of patients with a serious chronic disease (Better Health).

I shared an update on the organization’s strategic plan earlier this week at a Department of Medicine meeting. On the agenda before me, was a presentation from Dr. James Mersey, Chief, Division of Endocrinology and Medical Director of GBMC’s Geckle Diabetes and Nutrition Center.

Dr. Mersey presented GBMC’s new Diabetes Initiative, designed to bring evidence-based and patient centered care to everyone with diabetes in our system. Dr. Mersey laid out a wonderful plan designed to bring experts to the bedside of everyone admitted to our hospital with diabetes. A certified diabetes educator from the Geckle Diabetes Center along with an endocrinologist will visit every admitted patient. At discharge, the patient’s diabetic care plan will be transmitted to the primary care physician, either through our electronic medical record, eClinicalWorks, or via fax for those who do not have the EMR. The diabetes educator will see the patient in follow-up if necessary and will be available to consult with the primary care team. For patients who are not in the hospital, standardized care protocols will be built into the EMR and consultations for difficult patients will become easier to schedule. The initiative will also include on-line and in-person educational updates for our primary care physicians. We will have the equivalent of a diabetes registry so that we can check back with patients and measure the effectiveness of our new system. This will then lead to clinical research to help further improve our care.

You see, Dr. Mersey understands that a major problem for diabetes patients is the fragmentation of their care and communication gaps between the experts, the patients, and those caring for the patients. He shared a story of a lady who had been in and out of our intensive care unit for the management of her diabetes because her plan kept being changed by her primary care physician once she left the hospital because he misunderstood the diagnosis. As Dr. Mersey was telling the story I had two thoughts; the first was that if that was someone I cared about, I would be pretty upset that my loved one had to go back to the ICU because of poor communication. The second thought that I had was that this was fixable by the type of designed system that Dr. Mersey was talking about. We can and we must do better! We can no longer rely on hard work and good intentions alone.

Anything that we do that better coordinates what has been a very fragmented system will make it easier to get to better health for those we are serving, and make for fewer trips to the ICU!

The work of Dr. Mersey and our wonderful diabetes educators is one example of how we’re focusing on the second tenet of continuous improvement and designing the system to get to the desired outcome - better health. We need to have our thinking caps on about how we bring evidence-based medicine to the patient no matter where he or she is in the system and to tightly connect what happens to a patient at every place in our system.

What ideas do you have to improve our fragmented healthcare system? Please share your thoughts below.