Cheryl Howard, Stephanie Monroe, Michol Popp, Michelle Rowe, Alyson Swinehart Spring 2012 NURS 440 OSP Project, Ferris State University

Providing diabetes services to outpatient and inpatient population in Grand Traverse & surrounding areas: Education Medical management High quality nursing care

25.8 million children & adults in US living with diabetes Cost of diabetes in U.S. was $174 billion in 2007 Diabetes complications include: Heart disease Stroke Hypertension Blindness Kidney disease Neuropathy Amputations

Internal Environment No diabetes clinics in Grand Traverse or surrounding counties providing inpatient and outpatient diabetes services Need for diabetes clinic services providing dietician, physician and nursing care Need for collaboration with hospitals and primary care offices External Environment 1 million adults in Michigan have diabetes Higher prevalence of diabetes in Michigan than US Higher rate in counties surrounding Grand Traverse than in rest of Michigan Grand Traverse area has high rates of obesity, inactivity and older population

At Traverse Community Diabetic Services our purpose is to provide exceptional diabetes education, medical management, and provide high-quality nursing care for both acute clients in an inpatient setting as well as on an outpatient basis to diabetics within the community. We strive to provide a multidisciplinary approach to the care of the diabetic client and are committed to assisting our clients in managing a healthy life with diabetes.

Clients have the right to: Respect & dignity Person centered, non- discriminatory care High quality nursing and disease management Highest level of functioning possible Nurses have a duty to: Uphold professional nursing standards Advocate for clients’ rights and needs Provide evidence based, holistic care to promote health and well being of clients & community

Provide education, counseling and direct care relating to type 1 and 2 diabetes on an inpatient and outpatient basis. Provide compassionate care to all clients that services are provided to. Diabetes education resource for the Traverse area community. All care given is supported by current, evidenced based practice. Increase awareness of diabetes risk factors, signs and symptoms to members of the community. Care, education and services will be provided based on the needs of the individual and the community. Improve the quality of life of those living with diabetes!

1. To educate the community about awareness, prevention and management of diabetes by providing public education seminars and screening on a monthly bases. 2. To assist clients and families in establishing initial care and education of diabetes both inpatient and outpatient. 3. To provide scheduled ongoing care of diabetes as recommended by the health care provider. 4. To provide care in an interdisciplinary way to communicating with primary health providers and consider referrals to specialist assessment when indicated.

5. To improve the quality of life for patients living with diabetes as evidenced by less diabetic complications. 6. To provide comprehensive care for diabetes that aims not only to treat the disease, but to minimize the impact it has on our clients’ lives as evidenced by less hospitalizations. 7. To reduce morbidity and mortality rate by 5% in the community over the next 10 years. 8. To have more than 90% of clients with diabetes have two A1C tests done at least three months apart to ensure adequate glucose control for our clients.

RN Clinic Director Physician Midlevel provider Registered Nurse Registered Dietician Clerical Support We offer services in the least complicated manner possible. Using a phase one shared governance structure lets the nurse executive retain decision making authority while staff is responsible for practice issues and determining roles, functions and processes.

RN Clinical Director Perform leadership functions of governance and decision making. Coordinate all planning, organization and directing of financial funds. Collaborate with all staff member and run day-to-day operations. Maintain a safe and effective environment where diabetes management is a shared goal. Registered Nurses Collaborate care between physician, nurse practitioner, and dietitian. Provide professional care to clients using the nursing process to achieve desired outcomes. Report and collaborate with RN clinical director Develop and maintain client plan of care Physicians Provide direct and indirect care to impatient and outpatient diabetic clients Collaborate care with nurse practitioner, dietician and nursing staff. Mid-Level Nurse Practitioner Provide direct and indirect care to impatient and outpatient diabetic clients Identifies patient needs, skills and knowledge needed to manage diabetes Collaborate with the physician, dietician and nursing staff. Registered Dietician Develop specialized diets for diabetic patients Teach patients and families the importance of nutrition, diet and food selection. Evaluate how patients respond to their specialized diets and make adjustments when necessary Teach class about diet, nutrition and food related to managing diabetes. Clerical Support Operation of office front desk and schedule clients appointments. Assist clinical staff with daily office operations Handles the filling and finances for the clinic in collaboration with the RN Clinical Director for budget purposes.

Advertising Salaries Benefits Operating costs Supplies Equipment Funds & Revenue Critical Appraisal

For staff recruitment & community exposure: 1.American Diabetes Journal One month ad in the American Diabetes Journal- $4, Local newspaper (Record Eagle) Three day ad $ Brochures & flyers to hospital & healthcare organizations 4.Free electronic resources E-Bay Craig's List Facebook

Fringe Benefits: $8,000/employee

Operating Expenses Cost Annually Electric, Gas, and Heat$ 13,000 Water$ 3,360 General Waste$ 12,000 Medical Waste$ 3,400 Phone System$ 16,000 Medical Supplies$ 16,400 Office Supplies$ 19,600 Postage$ 2,000 Advertisement$ 17,000 Insurance$ 20,000 Total$122,760 REVENUE & FUNDING Grants Donations Medicare Part A Medicare Part B Blue Cross Blue Shield Priority Health

Expenditures for staffing, advertising and operating costs are justified due to the need of comprehensive, high quality, evidenced based care for diabetic patients. Clinic has potential to grow and expand over time Funding will be obtained from multiple sources that assist in operating clinic and contribute to the research knowledge base of diabetes care

Traverse Community Diabetic Services Clinic created to address serious identified need Serving patient population with high rate of diabetes Mission statement, philosophy & goals support need Plan created for staffing, advertisement and budget Together We CanWe Can Make a Difference!Make a Difference! Photo Credit: healthcarecommunication.worpress.com

American Diabetes Association (2012). Diabetes statistics. Retrieved from Centers for Disease Control and Prevention (2012). County level estimates of obesity-state maps. Retrieved from Centers for Disease Control and Prevention (2012). County level estimates of leisure-time physical inactivity-state map. Retrieved from Mancini, M. E. (2011). Understanding and designing organizational structures. In P. Yoder- Wise, Leading and managing in nursing (5th ed., pp ). St. Louis, MO: Elsevier Mosby. Michigan Department of Community Health. (2011). The impact of diabetes in Michigan. Retrieved from U.S. Census Bureau (2010). Profile of general population and house characteristics: Retrieved from productview.xhtml?src=bkmk. U.S. Department of Health & Human Services (2012). Calculate your body mass index. Retrieved from

ORGANIZATIONAL STRATEGIC PLAN PROJECT: The object of this assignment is to familiarize you with the workings of an organization. You will be working in small groups of 3-4 students to develop a new healthcare service. It can be a program, a clinic, a health center, a care delivery system, or a department. You are only limited by your imagination and the group’s agreement! If any of the group members have a project or service he or she is working on or want to work on related to current or future employment, feel free to use this assignment to assist in its development. Academic work is even more valuable when students can utilize assignments to support them in their work environments. This is going to be an on-going project with assignments due every few weeks and a presentation to be presented at the end.