SeaMar Community Health Center
SeaMar's most recent success of implementing a Diabetes Registry in real time each day, has been a work in progress. I believe it has been so successful because of their fantastic attitude and readiness for change.
SeaMar Community Health Center is one of the pilot sites for Pursuing Perfection Project in Whatcom County. They have done an amazing job over the past few months, and here are some of the reasons why. The Clinical and Reception Staff and Physicians are upbeat, open and receptive to change, deliver respectful caring and compassionate care to a diverse patient population , staff are bilingual and speak Spanish and are very supportive of one another as individuals. It has been my pleasure to work with this dynamic group of people as their Process Facilitator.
Let me share with you some of their accomplishments in Celebration of their success:
July 2002 - Start referring Diabetic and /or Congestive Heart Failure patients to a CCS (Clinical Care Specialist).
August 2002- Clinical Staff Trained on LastWord Registry Data Entry.
September 2002 - Joslin Diabetes Center Presentation to include Patient Education Groups in English and Spanish; Patient Focus Groups in Spanish led by Health Educator regarding email access, group visits, and telephone consultations.
October 2002 - Computer Touchscreen Patient Satisfaction Survey implemented; Diabetes Group Visits in Spanish piloted.
November 2002 - Retrospective Diabetic Chart Reviews with data entry in progress.
December 2002- SeaMar's Annual Children's Christmas Party. It was my pleasure to volunteer on a Saturday with their staff and physicians in serving a delicious hot luncheon followed by the appearance of Santa Claus and Mrs. Claus in a gift giving celebration for those in need. This is just one example of SeaMar's caring and compassionate care demonstrated toward their patients on their day off from work.
January 2003 - In preparation for implementing the Diabetes Registry in February, a decision was made to transition to a different lab vendor. The lab transition to NWRL was very smooth and implemented in January; Berdie Safford MD did a presentation on the Diabetes Registry to all staff and physicians; Erin Baumgart and Jeanmarie Mueller did a presentation to the physicians on the Diabetes Reports available on Crossroads; Joslin Diabetes Center Presentation to include Patient Education Groups in English and Spanish;
February 2003 - Diabetes Registry Implementation" Live" - WOW!
Milestones Achieved as of February 2003 :
1. Scope of Implementation- Our initial scope for the Diabetes Registry Implementation was for 2 Clinical staff and 2 Physicians - by the end of the second week, we fulfilled a request to spread to 9 Clinical staff, 2 PST (Patient Support Techs), 5 MD's and 1 PA-C.
2. Mono-filament Foot Exam-some physicians are now having their clinical staff do the mono-filament foot exams .
3. Smoking Cessation -When the Clinical Staff assess the patient, they are addressing and initiating Patient Behavioral Change Goals - Diet, Exercise and Smoking are discussed. Several patients in the first week of the Diabetes Registry Implementation were referred to Smoking Cessation Programs, just because the Clinical staff asked the question, "Would you be interested in stopping smoking?". One patient stated while I was in the room, "I would love to, but I thought the patches would be too expensive, are there other things I can do? ". WOW, what an opportunity!
4. PSAT (Patient Satisfaction Survey) Score for SeaMar over the past 3 months demonstrated a statistically significant and substantial increase from 63.8 to 69 .3 over all score .
They are able to do today's work today -at times even in the room with the patient; doing data entry for every diabetic patient within 24 hours; running diabetes reports to capture all that is needed in a visit. The behind the scenes work began several months ago, I will try to chronicle where we began: Initially, we had to identify the Diabetic Patient Population followed by a chart review; Patients were then registered in LastWord with the Clinical Snapshot data; Processes were identified; Lab transition identified as a need; Reception, Clinical and Staff Training occurred. They are having receptionists note on the schedule that the patient is there for a diabetes visit; the PST print the Diabetes reports attach them to the charts; the clinical staff review the charts prior to the appointment for medications (ASA, ACE Inhibitors,ARB's) which is also confirmed with the patient when they come in and the last Opthalmology Consultation. If a patient did not have an eye appointment in the last year, a referral form is placed on the chart. A lab card is also placed on the chart so that patients are advised to come in 1 week prior to their appointment to have their labs drawn as needed for Hgb A1c , LDL, etc. All patients are having a visual foot exam done at every office visit. If a mono-filament foot exam is needed a mono-filament kit will be set out. Recalls, are also now in place with the Patient Exception Reports being run the first of every month for each MD. Patients are now being identified and scheduled for a follow-up appointment.
As a result of all of the above, this they have transformed how they deliver patient care to diabetics by becoming a proactive prepared care team!
Your thoughts and comments are welcome!
Terry Wagner RN BSN
Pursuing Perfection Project
800 E. Chestnut Street
Bellingham, WA 98225
Cell # (360) 319-9786
Email twagner@peacehealth.org
