Coordinating a Diabetes program in North Western PA in a rural setting can face many challenges.
Many of our patients are referred to us from their primary care physician when they are diagnosed with Diabetes, or if the physician feels that they are poorly managing the disease and need additional assistance.
But so often these patients are reluctant to coming to the hospital to talk to an educator. (Our outpatient program is located within the hospital) We often hear the following:
- I know what to do because everyone in my family has it.
- My neighbor told me what to do.
- I don’t have a way to get there to see you. It’s just too far to go to talk to someone.
- Someone said if I don’t eat anything white I will be okay.
We are also often battling a no call/no show population.
Our first efforts following the physician referral is to contact the patient by phone. Often we are leaving messages, sometimes 3-4 before we hear back from a patient. Sometimes they do not return our calls.
We have sent letters to the patients that are difficult to reach explaining that we had an order for a consult and include the contact information for our department. Sadly, this as well often yields little response.
So…. What do we do???
We continue to be creative in our community for our out- reach programs.
We participate in the hospital sponsored wellness events, where our lab performs biometric screenings; I have spoken and been available to discuss information on the results when glucose levels are elevated.
We have public speaking events at the Senior Centers, Local Nursing Homes, Senior Wellness banquets where both I and the program dietitian speak to the public. We always include information about our services at these events and encourage the attendees to discuss the information with their physician if they feel that they can benefit from our program.
Daily the Inpatient hospital census is reviewed and I offer to meet and discuss diabetes management with all patients that have an HgbA1C greater than 8.0. I also meet with anyone newly diagnosed with diabetes to assure that they are prepared to leave the facility, and I initiate our outpatient services at this time whenever possible.
We host an annual Diabetic Health Fair in November. We include Keynote speakers, the Blind Association for free vision screens, local homecare agencies assist with blood pressure, finger stick glucose levels, and Weights. Our YMCA as well as Rehab departments have information on exercise. Our local Social Service agencies along with the hospital social worker participate in stress management. Our local Drug and Alcohol commission provides information on Substance use.
Along with this we have our hospital department’s address their services related to management of diabetes, this includes the Sleep lab program, cardiopulmonary department, our inpatient pharmacy as well as 2 outpatient pharmacies that will bring a display of diabetic products.
We have our local ophthalmologist and laser eye center provide information on eye disease and treatment.
A local podiatrist provides information, foot models and diabetic shoe information.
We have local organic farmers that discuss healthy and whole foods.
We have national companies participate as well which in the past have included Sanofi, Lilly, Novo Nordisk, Bayer and One touch, Omni Pod, Abbott
I am so very proud of this event. The hospital staff members all pull together, the community looks forward to attending and our facility administration is very supportive of this.
We have held classes that are specifically tailored to the Individual with Diabetes and Driving Trucks. We researched the information on Maintaining your CDL with Diabetes. We have had one successful class with this population; sadly we have also had an attempt to host this class with no interest.
So, what do we do as Diabetic Educators to continue to grow our programs? You heard our story…… what about yours?
I look forward to all feedback that our blog may generate.
Gretchen Frye, RN, BSN
AADE North West PA Program CoLead
Clarion Hospital Diabetes Program Coordinator