PLAN › What were the improvement aims?
Increase patients’ participation in our quality improvement process Increase patients’ engagement in their health care
DO › What improvements did we achieve?
Participation Engagement
STUDY › What did we learn
What obstacles did we face? How did we overcome them? What would we do differently?
ACT
Based on what we learned, what are the next improvement steps?
Participation › Patient Advisory Panel › Diabetes Group Visits
Engagement › Patient Activation Measure (PAM) survey
› Emphasize face-to-face health coaching
visits (rather than distance visits)
ď‚ž
New patients (number of visits)
30 days HTN DM Lipids Weight Loss Smoking
face to face phone face to face phone face to face phone face to face phone face to face phone
60 days
2 2 3 1 2 2 2 2 1 3
face to face phone face to face phone face to face phone face to face phone face to face phone
90 days
1 2 2 2 1 2 2 1 1 2
face to face phone face to face phone face to face phone face to face phone face to face phone
1 1 1 1 1 1 1 1 1 2
ď‚ž
Established patients (number of visits)
30 days HTN DM Lipids Weight Loss Smoking
face to face phone face to face phone face to face phone face to face phone face to face phone
60 days
1 1 1 1 1 1 1 1 1 2
face to face phone face to face phone face to face phone face to face phone face to face phone
90 days
0 2 0 2 0 2 1 1 1 1
face to face phone face to face phone face to face phone face to face phone face to face phone
0 1 0 1 0 1 1 1 1 1
Participation › First Patient Advisory Panel meeting June 27, 2012 35 suspects 6 patient attendees 2 doctors introduced and left Jeff Biehl, Krista Stock
Participation › First Patient Advisory Panel meeting › Feedback: Pre-Survey re knowledge and health coaching 18 questions (details available on request) Average 3.33/4
Participation › First Patient Advisory Panel meeting › Feedback: Post Survey
Participation › First Diabetes Group Visit September 27, 2012 555 suspects 3 patient attendees, plus 1 spouse 1 health coach
Participation: Diabetes Group Visit Format
Pre-session planning ›
Ask patients: what are your problem areas in managing your diabetes?
Part 1: Discussion › For patients to learn from each other
What is your biggest challenge? What solutions do you have that might help others?
Part 2: Education › Design an education piece around the feedback you get from
patients
What do they want to learn?
Feedback
Participation › First Diabetes Group Visit Feedback: Training (3 questions): 5/5 Content Delivery (7 questions): 4.9/5 Application (3 yes/no questions): all “yes”
Participation › Second Diabetes Group Visit November 28, 2012 Zero patients
Engagement › First survey results › Initial statistics Venue
2011
2012
Total
Total
129
299
428
2
10
12
Office
14
23
37
Phone
67
45
112
unspecified
46
221
267
Obstacles › Few volunteers › Resistance to face-to-face visits › Some patients lost in health coach transition
Overcome › Direct doctor-to-patient appeal
Do differently › Lower our expectations
Next steps › Repeat survey › Continue meetings › Measure outcomes › Attempt to correlate increased
participation/engagement with improved clinical measures