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)

New patients (number of visits)

HTN face to face 2 face to face 1 face to face 1

phone 2 phone 2 phone 1

DM face to face 3 face to face 2 face to face 1

phone 1 phone 2 phone 1

Lipids face to face 2 face to face 1 face to face 1

phone 2 phone 2 phone 1

Weight Loss face to face 2 face to face 2 face to face 1

phone 2 phone 1 phone 1

Smoking face to face 1 face to face 1 face to face 1

phone 3 phone 2 phone 2

30 days 60 days 90 days

Established patients (number of visits)

HTN face to face 1 face to face 0 face to face 0

phone 1 phone 2 phone 1

DM face to face 1 face to face 0 face to face 0

phone 1 phone 2 phone 1

Lipids face to face 1 face to face 0 face to face 0

phone 1 phone 2 phone 1

Weight Loss face to face 1 face to face 1 face to face 1

phone 1 phone 1 phone 1

Smoking face to face 1 face to face 1 face to face 1

phone 2 phone 1 phone 1

30 days 60 days 90 days

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

Email 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