Jeanie Schmidt Free ClinicHerndon, VA

Kathy Gold, RN, MSN, CDE

STRENGTHWEAKNESS

OPPORTUNITYTHREAT

SWOT

Patient Strengths

• Empower patients, not as isolated, encourages sharing feelings and frustrations

• Information learned in class moving beyond patient to family and friends

• Information shared by patients that may not have been shared with HCP during typical visit

• Dig deeper into patient’s feelings• Learned goal setting• Built a trusting environment• Breaks down ethnic barriers• Decrease wait time • Group support• Increased motivation

Staff Strengths

• Support of clinical staff and administration• Everyone on the same page• New skill development• Motivating to staff• Something new• Attracted new staff• Increase availability

Clinic Strengths

• Accommodate more patients• Save physician time for complex patients• Frees up time for more acute patients and high

risk patients to be seen by other providers• HCP able to follow patient more closely• Build a relationship with patient• Group visits accommodate lower risk patients

that will benefit from intervention but condition may not warrant extra attention

Clinic Weakness

• Organization may be thinking too small or don’t share expanded vision

• Don’t see growth• Cost• Resource intensive• Space required• Requires a 2 hour block of time• Sustainability - volunteer nature of team

Patient Weakness

• Language barrier• Not appropriate for all patients• Hypertension and diabetes in one group• New terminology – goal setting• Cultural competence• Time offered, not available at night or weekend• What is “life after group visit?”• Culture • Gender• Recruitment understand what visits means

Staff Weakness

• Resistance from some staff members• May not be something all staff can do• No NP’s to engage in process• Don’t like change• May require training• Not part of job description

Staff Opportunities

• Two new MD’s• Identified successful training programs –

certificate for promotoro or health educator

• Engage staff– Share education among experts –

pharmacist, CDE, podiatrist, dietitian• Develop job description for group visit

providers

Patient Opportunities

• Develop phase 2 – – Diabetes group visit– Hypertension group visit

• Consider drop in group visits• Develop curriculum• Develop advanced curriculum • Created group education class for complex patients• Enroll more patients• Divide groups into cultural groups• Need entry and exit criteria• Spread visits from monthly to every 3 months

Staff Threats

• Afraid to move out of comfort level• No back-up in case of emergency• HCP may be forced to participate• May not be in favor of concept• Change• Continuity • Sustainability• Lack time• Training of staff• Transition

Patient Threats

• Recruitment– Patient identification – Entry and exit criteria

• Too sick for group visit• Transition

– Primary care to group visit– Group visit to primary care

Questions?

Kathy Gold, RN, MSN, CDEDiabetes Research and Wellness Foundation 800-941-4635kathy@kathygoldcde.org

Virginia Diabetes CouncilVirginia Diabetes Plan 2008-2017www.virginiadiabetes.org