Revitalization of a Diabetic Collaborative

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Revitalization of a Diabetic Collaborative
(The Viagra Approach)
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How we got here

• Start 1998
• 1 site, 1 provider
• too complex as presented
• Was not integrated into QI or any other system,
  stood alone
• 1998-2000
• Gung Ho, good progress, lots of enthusiasm
• 2000-2002
• Provider issues
• Heavy staff turn over without replacements
• Over whelming paper work

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How we got here

• 2002-2004
• HCH started separate team
• All were on the team
• Lost our Champion
• Mixed messages on leadership/responsibility
• Causing hurt feelings and misunderstandings
• PECS vs The Computer
• The peckerwood

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Directors Creed

• There must be buy in from the top
• If you dont believe in the collaborative. no
  else will
• You need to be a combination of
• Preacher
• Coach
• Therapist
• Drill Sergeant

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The Challenge

• Strive for buy in from Providers, Managers,
  Nurses, Clerical
• Explain why it is important
• Good Patient Care
• Important Research
• Basis for Future Funding
• Job Security
• Good Patient Care

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Stagnation

• Keep Things Moving
• Infusion of New Members
• New Energy
• New Eyes
• New Ideas

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Self (program) Examination

• Admit Mistakes but then let it go and move on
• We were too exclusive
• Medical Director
• Lab
• Dental
• Nursing
• Not all clinics were initially included

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Self (program) Examination

• Passion didnt spread beyond Medical Director
• Some Providers refused to follow diabetic
  protocols
• Some didnt want to deal with PECS
• Some sabotaged the program by talking negatively
  about it to other staff

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What is Different Now

• A larger representation of the staff
• Medical Director
• Family Practioner
• Internist
• Lab
• Dental
• Nursing

• Nutrition
• Family Support Services
• Geriatric Case Manager
• Collaborative Coordinator

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What is Different Now
Jumping through hoops is not bad once you realize
that you are the one deciding to jump.
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What is Different Now

• Reality Check
• What the Feds giveth, the Feds can taketh away
• Serenity Prayer
• "God grant me the serenity to accept
• the things I cannot change, courage to change
  the things I can, and the wisdom to know the
  difference."
• The Gold Rule
• Whoever hands out the gold makes the rules

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What is Different Now

• Matthew 310
• Yes, every tree that does not produce good fruit
  will be chopped down and thrown into the fire.

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STOP