Improving Diabetes Care and Outcomes on the South Side of Chicago

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Chicago Family Health Center

Team pictured from left to right: Maria Vargas, Rebecca Gallegos, Daisy Gallardo, Sherie Withers, Laura Escobedo, Nikie Parikh


Project Team

Administrative Champion: Warren Brodine, CEO
Administrative Champion: Maria Vargas, RN, Director of Comprehensive Services
Back Office Champion: Daisy Gallardo, Diabetes Educator
Front Office Champion: Rebecca Gallegos, RN, Chronic Care Nurse
Provider Champion: Nikie Parikh,MD
Back Office Champion: Sherie Withers, Nutritionist
Other Team Members: Laura Escobedo, Referral Coordinator; Sarah Schutz, Grants Manager; Elizabeth Ortega, Dental Assistant; Reuben Rosario, Performance Improvement Specialist; Lakara Banks, Health Educator; Efren Tirado, Health Educator

 

Sometimes patients forget what medicines they are taking, how they work, and when to refill them.  To help with this problem, the Chicago Family Health Center team created wallet-sized medication cards for patients to carry and use to keep track of their meds.  The cards also promoted conversations between the health provider and patient when they filled out the card together during appointments.

Often there is not enough time during a medical appointment for patients and providers to talk a lot about diabetes management.  To help with this problem, the team visited other local community health centers and learned how to conduct diabetes group visits (shared medical appointments).  The visits bring together a group of diabetes patients for 90 min to learn about diabetes self-management, ask clinical questions to the clinical staff, and support each other emotionally. During the visit, each patient leaves the group to meet individually with their doctor.  The visits take place every 3 months, instead of one-on-one follow-up visits with their doctor.

Now, after recently implementing a new electronic medical record system (EMR), the team will use data from their system to identify and track patients who need specialty care (e.g. podiatry, neurology, endocrinology, etc).

All clinical staff from surrounding Chicago Family Health Center locations have been invited to participate in Provider Workshops.  Though originally designed for physicians and nurse practitioners, Chicago Family chose to also allow support staff (nurses, medical assistants, social workers, etc) to receive the training.  Workshop topics including cultural awareness, behavioral change, and the importance of shared decision-making were valued by all participants.

The Diabetes Empowerment Classes are coming soon to this site.

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