Shabelle Diabetes Eban Project
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Transcript of Shabelle Diabetes Eban Project
Shabelle Diabetes Eban Shabelle Diabetes Eban ProjectProject
Eban Experience Session II
June 17, 2011
AimAim
• Improve Ethiopian diabetes care at HealthPartners Riverside, Center for International Health and Midway clinics by a series of three diabetes group classes and 1:1 visits in a period of six months
Team MembersTeam Members
• Nimo Elmi, Riverside rooming nurse • Tigist Ayano, Riverside interpreter • Carol Engelhart, RN • Rebecca Straub & Tracy Newell,RD • Amber Peltier, Pharm D • Asha Ali & Mohammed Hassan, community
advisors• Judy Jerde, nursing project coordinator• Dana Langness, quality coordinator
WorkflowWorkflow
WorkflowWorkflow
PDSA # – 1
Objective Identify and invite patients to attend Ethiopian diabetes classes.
Prediction 1. We will find Ethiopian Oromo and Amharic diabetes patients to come to class
2. We will find Ethiopian patients who have a primary language of Oromo or Amharic and a secondary language of English to come to class
3. We will call patients, send invitations or invite them at an office visit
Population Initially, patients with diabetes who receive care at Riverside Clinic who speak Amharic or Oromo OR who have possible East African names. Later, patients who receive care at Midway or Center for International Health were included.
Plan-Do-Study-Act (PDSA) Cycles:Plan-Do-Study-Act (PDSA) Cycles:
Plan-Do-Study-Act (PDSA) Cycles:Plan-Do-Study-Act (PDSA) Cycles:
PDSA # - 1TEST CYCLE 1 Start Date: 3/21/11 End Date: 4/8/11
Plan Created colorful invitations in Amharic and Oromo language and with Ethiopian pictures that had dates for the three class. Identify Amharic or Oromo speaking patients. Contact patients with East African names to ask their country of origin.Use interpreters to contact patients who do not speak English.Invite patients to attend diabetes class.
Do Amharic class – unable to find enough Amharic speakers from Riverside patient list. Expanded scope to include patients who receive care at Midway or Center for International health. 6 indicated they would attend, 2 attended Oromo class – interpreters contacted patients numerous times before this class, told patients “It is important for you to attend”. 22 indicated they would attend, 19 attended.
Study Need at least 5 participants for an effective group class.Numerous contacts by a trusted interpreter appears to increase class attendance.
Act Continued efforts to build relationships and increase number who actually attend each session.Mail invitations 10-14 days in advance due to going through corporate mail. Give invitations to doctors and nursing staff to hand out to Ethiopian patients and have them register when they are at an office visit.
Plan-Do-Study-Act (PDSA) Cycles:Plan-Do-Study-Act (PDSA) Cycles:
PDSA # - 2
Objective Develop diabetes education content that is culturally appropriate for East African patients.
Prediction At the conclusion of the series of classes (November 1, 2011):1) 60% of class participants will meet their monitoring goals2) 60% of class participants who began with a Hgb A1C of > 8.0 will
improve by > 0.3% 3) 60% of class participants will improve their Modified Morisky
Adherence scale
Population Patients with diabetes who receive care at Riverside, Midway or Center for International Health Clinics who speak Amharic or Oromo OR who are from Ethiopia who attend the ethnic diabetes classes at Riverside Clinic.
Plan-Do-Study-Act (PDSA) Cycles:Plan-Do-Study-Act (PDSA) Cycles:
PDSA # - 2TEST CYCLE 1 Start Date: 5/3/2011 End Date: 11/1/2011
Plan Customized content presented by nurse diabetes educator, including simplified visuals, materials translated into Amharic and content appropriate to Ethiopian cultural background.
Interpreters present at class.
Class meal of Ethiopian foods.
Participants complete survey at each class.
Obtain HgbA1c at first and last class.
Do First class: Amharic – 2 (of 6) attended, Oromo – 19 (of 22) attendedBecause of low turn out at the first Amharic class, the team decided to partially combine the classes. They will be held at the same time, meal will be as a group, break into language group for teaching.Survey completion is time consuming, have participants complete at first and last class.Second class: Amharic – 1 (of 4) attended, Oromo – 7 (of 24) attended
Study
Act
How have you integrated your How have you integrated your community advisor into your community advisor into your
improvement work?improvement work?• Assisted with development of class
invitation.
• Community advisors & Riverside staff who are members of the East African community helped team members have a better understanding of food preferences leading to more appropriate education.
• Some attendance at team meetings.
Successes & ChallengesSuccesses & Challenges
• Successes
– Diabetes staff learning that improves their ability to help patients
– Patients reporting that they are making changes that will improve their health
• Challenges
– Variable class attendance