Most people think of diabetes
as a disease associated with
blood sugar counts and insulin,
not as the nation's fifth-leading
cause of death.
About 17 million Americans have been diagnosed with diabetes. The disease accounts for one out of every four dollars spent in health care and significantly increases the risks of developing cardiovascular disease, hypertension, kidney disease and blindness in those who have it. The number of people who have diabetes in the United States is growing every year.
Three years ago, the Volunteer
Hospital Alliance chose
WellStar Health System as one of
eight national sites to launch its
Target Diabetes program. Well-Star has been fighting diabetes
and its consequences ever since,
and the major weapon in its
arsenal is education.
"In Georgia, the prevalence of diabetes is 8 percent higher than the nation as a whole. It is estimated that almost 10 percent of all Georgians have diabetes, and one out of three are not even aware they have the disease," said Kimberly Roberts, RN, BSN, Target Diabetes specialist with WellStar Health System.
WellStar took a four-pronged approach to the problem, addressing it in the clinical hospital setting and in outpatient physicians' offices, raising community awareness and teaching diabetics to manage their disease.
"We initiated strict glycemiccontrol
guidelines in our critical
care units at Douglas, Cobb and
Kennestone hospitals, based on
national research conducted
by the national Target Diabetes
committee," said Linda Simmons,
RN, director of disease
management at WellStar. "We've
seen excellent results, with
nurses able to get patients'
blood sugar levels down to normal
range within six hours and
keep them there, thereby reducing
the mortality and morbidity
rates."
WellStar's A1c test average for its patients has dropped from 8.2 percent in 1999 to 6.86 percent at the end of 2005. The A1c test is used primarily to monitor the glucose control of diabetics over time.
WellStar formed a multidisciplinary steering committee of nurses, doctors, nutritionists, pharmacists and others who worked with diabetic patients to oversee the initiative. They've worked with The Center for Healthcare Transformation, public health departments and other agencies to launch a community education effort to increase the public's knowledge about the disease.
The health system also set new standards of care for outpatient
physicians, employees and
affiliates of the hospital, and it
monitors the results through
chart reviews.
"We want to be known as a center of excellence for the delivery of diabetes care," Roberts said.
WellStar has established four
American Diabetes Association certi
fied centers to help outpatients
manage their diabetes. At
each hospital, certified diabetes
educators run the centers.
"It can be very depressing
to be diagnosed with a chronic
disease," Roberts said. "We give
our patients the tools they need
to understand diabetes and encourage
them to control it.
"We're not the diabetes
police. Our job is to motivate,
educate and encourage them to
take tiny steps - like not eating
that bowl of ice cream at 2 a.m.
- and to praise them when they
succeed."
WellStar's efforts not only
have helped diabetics reduce
their health risks but also may
have prevented others from getting
the disease.
Roberts was inspired to make diabetes a specialty by a friend who didn't control his diabetes well. He got a tiny pebble in his shoe, and, because he couldn't feel the pebble, he got an infection that spread throughout his whole body.
"Through lack of education
and self-management, a good,
kind man lost his life to diabetes," Roberts said. "I think about
that when I walk in the door in
the morning."
Roberts also thinks about a young diabetic mother who ended up in a WellStar ICU because of a postpartum infection.
"She was very ill, but because we had an intensive insulin program, she walked out of the hospital and is back with her family," Roberts said.
More than just an initiative,
the fight against diabetes has
become part of the WellStar culture
and has touched all aspects
of care, Simmons said.
"We're passionate about this
program and really proud of
the results. The initiative is not
going to go away," Simmons
said. "It's exciting to be part of
a health care system that wants
to and is making a difference.
We're making huge strides in
creating a healthier community."
"But we have our work cut out for us," Roberts added. "Everyday we see new patients, and it's like starting all over again. Every patient is important, which is what keeps us motivated to keep working."