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Joy Cornthwaite MS, RD, LD, CDE Diabetes Educator Registered Dietitian Manager McGovern Medical School at UT Health UT Physicians Women’s Center Houston, Texas
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Clara Ward MD, MPH Maternal Fetal Medicine Physician
Assistant Professor Division of Maternal-Fetal Medicine Department of Obstetrics, Gynecology & Reproductive Sciences McGovern Medical School at UT Health Houston
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Rita Willis RN, MPH Vice President, Chief Operations Officer McGovern Medical School at UT Health Department of Obstetrics and Gynecology Houston, Texas
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Disclosure to Participants
Notice of Requirements For Successful Completion Please refer to learning goals and objectives Learners must attend the full activity and complete the evaluation in order to claim continuing education credit/hours Conflict of Interest (COI) and Financial Relationship Disclosures: Presenter: Joy Cornthwaite, MS RD LD CDE – No COI/Financial Relationship to disclose Presenter: Clara Ward, MD – No COI/Financial Relationship to disclose Presenter: Rita Willis, RN MPH – No COI/Financial Relationship to disclose Non-Endorsement of Products: Accredited status does not imply endorsement by AADE, ANCC, ACPE or CDR of any commercial products displayed in conjunction with this educational activity Off-Label Use: Participants will be notified by speakers to any product used for a purpose other than for which it was approved by the Food and Drug Administration.
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Why do we care about glucose management during pregnancy?
Placenta mediated insulin-resistance Fetal impact of hyperglycemia Long-term implications for maternal health Effective treatment plans for diabetes require a comprehensive team of professionals working and communicating effectively for the benefit of our patients and their babies.
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Implications for the fetus
GGl Congenital Anomalies PTB IUFD Macrosomia Perinatal asphyxia/birth injury GLYCEMIC CONTROL CM RDS Shoulder dystocia Hypoglycemia Jaundice Low Ca/Low Mg
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Suite 360 Vision Project: Embedding Diabetes Specialist Across the Four Trimesters of Pregnancy
Unified philosophy Cohesive space Comprehensive team Scheduling We are dedicated to providing 360° care to our patients who are living with diabetes through effective treatment plans for diabetes require a comprehensive team of professionals working and communicating effectively for the benefit of our patients and their babies. But first, there needs to be established… 1st - Departmental philosophy and mission 2nd - Development of a comprehensive team 3rd – Cohesive space, scheduling In order to support effective treatment plans
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Joy Cornthwaite MS RD LD CDE
Sean C. Blackwell MD Chair, Department of Obstetrics, Gynecology and Reproductive Sciences Director, Larry C. Gilstrap M.D. Center for Perinatal and Women’s Health Research Rita Willis, RN, MPH VP, Chief Operations Officer Diabetes Program Champion Clara Ward MD, MPH Assistant Professor, Division of MFM Diabetes Program Coordinator Joy Cornthwaite MS RD LD CDE Dietitian Manager and Diabetes Educator Assistant Diabetes Program Coordinator
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Suite 360 Vision Project Embedding Diabetes Specialist Across the Four Trimesters of Pregnancy Counseling Systems Nano Micro Macro
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Mother living with diabetes Office staff and support
Nano Mother living with diabetes Micro/ Macro Office staff and support Physicians and clinicians Micro
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Patient Centered: Personalized and Comprehensive
Individual needs Attention to support system Self-efficacy implement and sustain recommendations HALO effect Patient and their personal support team Primary OB Physician Specialized Maternal Fetal Medicine Physician Nurse Practitioner / Physician Assistant Registered Dietitians, Certified Diabetes Educators Medical Assistants Diabetes Trained Support Staff
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Suite 360 Vision Project 1st trimester
2nd and 3rd trimesters 4th trimester post partum care Expectations and responsibilities Etiology of disease, considerations in pregnancy AADE7 Self-care behaviors Resource and Supply management Review of previous as needed Continued support for self care behaviors Medical treatment management, as applicable Medication changes Support for resources and supplies Expectations and responsibilities Considerations post pregnancy Transition/return to primary care manager and/or specialist care Case mgmt and resources Suite 360 Vision Project We make it worth it! <div>Icons made by <a href=" title="Freepik">Freepik</a> from <a href=" title="Flaticon"> is licensed by <a href=" title="Creative Commons BY 3.0" target="_blank">CC 3.0 BY</a></div> Pregnancy is an opportunity to impart knowledge. We aim to support positive sustainable changes for each patient and her family, by establishing and growing self efficacy.
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Mother living with diabetes Office staff and support
Nano Mother living with diabetes Micro/ Macro Office staff and support Physicians and clinicians Micro
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Clinical Operations: Personnel Management
Responsive Leadership & Communication Team Maternal Fetal Medicine (MFM) Physicians, Nurses, Certified Diabetes Educators, Sonographers, Genetic Counselors MFM schedulers, Medical Assistants, MFM clinic staff Effective treatment plans for diabetes require a comprehensive team of professionals working and communicating effectively for the benefit of our patients and their babies.
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Clinic Operations: Enhancing Patient Care & Experience
Referral Management (Graph?) Internal External Productivity (Graph?) Appointment scheduling Linked Visits Minimized Cancellations, No shows Aligning program with patient needs and engagement, as well as clinical care process improvements. AADE DEAP Accreditation Central Scheduling - Assumed scheduling - Appointments are linked to others Insurance Verification We are fortunate to have a billing department that is responsible for insurance verification and coding procedures. Patients who have an appointment are contacted prior to appointment for discussion around insurance coverage and payment responsibilities and options. Cohesive physical space Check in —> each appointment within same suite Reduces confusion Maximizes patient and clinician time
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Amenities Snacks and Water Written education materials, teaching tools
Glucose monitoring supplies for immediate distribution* *insurance dependent Could we look at time to first glucose meter prior to use of fifty50 (we cannot name them in the presentation though)?
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Mother living with diabetes Office staff and support
Nano Mother living with diabetes Micro/ Macro Office staff and support Physicians and clinicians Micro
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Quality patient-clinician interactions
Efficiency more comprehensive care Satisfaction Outcomes Can we look at outcomes? Have they improved with diabetes educators present at UTP?
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MACRO Systems: Creating solutions
Team-based Remote monitoring Access, follow-up, QOL Patient Peer-support and centering Clinicians Documentation Reduction of time and efforts spent Multi-purpose effort Medicine and resource determinations Using a model similar to Triple AIM – adjusted 2/2 clinic processes, considerations, and needs Unique to high risk pregnancy versus care outside of pregnancy.
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Program Development “Starfish” Supporting the next generation
Resident physician education Training & research Family medicine, medical students, nursing students Evidence-based molding of clinical philosophy Supporting referring physicians Service promotion Lunch and Learns for Peers and their staff Title: Dr. Ward Systems – Micro: Starfish (explain?)
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Joycelyn.a.Cornthwaite @uth.tmc.edu
Questions?
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