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Learning Objective 1: Describe innovative interdisciplinary care coordination and teaching methods used in a clinic setting for pregnant women diagnosed with Gestational Diabetes.
Learning Objective 2: Describe how the application of the Kouzes Posner leadership model facilitated my leadership journey and contributed to project success.
Management of gestational diabetes (GDM) during pregnancy is critical for the delivery of a healthy newborn and requires consistent and relevant patient education and coordinated interdisciplinary care. While prevalence in Oregon is approximately 5% and 30% of those women will develop Type 2 diabetes within five years after delivery, a lack of consistency of GDM patient care models was identified across eight ambulatory nursing sites.
Purpose
Provide standardized, evidence-based GDM education and nursing care at Kaiser Permanente NW Obstetric clinics to ensure mothers receive consistent care and decrease the incidence of GDM related adverse outcomes.
Project activities
Nurse education, competency and care coordination varied between eight ambulatory nursing sites. An interdisciplinary team was established and pilot GDM group education visit co-facilitated by a nurse and dietician was initiated in March 2013. Pilot nurses utilized evidence based patient education strategies. Formal request for electronic case management tools submitted.
Evaluation Methods
Administer Patient Activation Measure (PAM) survey and collect patient evaluations.
Evaluation results
Pilot through July 2013. Staff report increased satisfaction with team-work. Patient evaluations of group education demonstrate high satisfaction. Conversely, 1:1 education using traditional didactic teaching technique reveals a theme of “too much information, overwhelming”. As a result of the project, standardized nurse education and competency requirements will be implemented, enabling nurses to deliver patient education using evidence based techniques. Electronic case management tool project is approved and will improve prompt identification and treatment of increasing blood sugars contributing to decreasing GDM related adverse outcomes.
Assembling an interdisciplinary team facilitated an accurate view of current processes and provided resources contributing to development of evidence based pilot project. Most pilot participants appreciated the opportunity to debrief emotions and clarify understanding with the nurse, dietician and other women with GDM.
Next steps
- Develop and implement nurse competency plan.
- Implement group education model regionally.
- Build electronic case management tools.
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