Theme ArticleDiabetes Education: Quality Improvement Interventions Through Health Departments
Section snippets
Background
The Commonwealth of Kentucky is suffering from staggering levels of diabetes: 11.4% of Kentuckians have been diagnosed with diabetes (ranked 4th nationally), and diabetes is the seventh-leading cause of death in the state.1 Diabetes is also a major threat to the financial well-being of Kentucky; the estimated cost associated with diabetes in Kentucky in 2006 was more than $2 billion.2 The overwhelming burden of diabetes necessitates that local health departments (LHDs) improve the delivery of
Study Settings
Study sites included six of Kentucky’s 56 LHDs that, like the rest of the state, consist of a mix of single-county (2) and district (4) departments that largely served rural areas. The study departments were chosen in 2006 by the Kentucky Department for Public Health (KDPH) as Diabetes Centers of Excellence, which, through support from the Kentucky Diabetes Prevention and Control Program (KDPCP), provide education and support to individuals with diabetes. The KDPCP provides DSME training and
Results
The QI projects implemented by the LHDs focused on two major themes: increasing community outreach to patients and providers (three projects) and improving internal operations related to the delivery of DSME services (three projects). Motivations for the projects were diverse. For example, one of the projects that focused on internal operations was targeted toward process improvement relative to departmental operations with a private Medicaid managed care provider. Two of the six QI teams
Discussion
The QI projects developed and supported during COACH 4DM led to improvements in DSME service-delivery outcomes. Although notable gains were seen in the number of patients receiving DSME, the number of patients completing an entire series of DSME classes increased by more than 100%. This is particularly notable because diabetes self-management requires comprehensive education. Patients who receive any amount of DSME can benefit, but those who complete an entire training series will be more
Acknowledgements
Funding for this research was provided by the Robert Wood Johnson Foundation through the National Coordinating Center for Public Health Practice-Based Research Networks. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Robert Wood Johnson Foundation. This project was also supported by the National Center for Research Resources, UL1RR033173, and is now at the National Center for Advancing Translational Sciences. The content is
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