Diabetes

How to make the organizational case for a diabetes prevention program

About 350,000 adults in Wisconsin have diabetes, while more than one-third have prediabetes, according to research cited by the state’s health department. To help people with prediabetes make the lifestyle changes they need to improve their health, a Wisconsin-based health system launched a National Diabetes Prevention Program (DPP) lifestyle-change program. Getting the program off the ground included highlighting important data to the right people at the right time.

Marshfield Clinic Health System (MCHS) brought together a team of key stakeholders to develop and launch a National DPP lifestyle-change program. Program leads relied heavily on backing from administration, as well as metrics to demonstrate the benefits and return on investment to the health system.

The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National DPP lifestyle change program based on their individual needs.

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Located in Marshfield, Wisconsin, MCHS serves a population of about 200,000 adult patients in primary care across 34 communities in northern, central and western Wisconsin. The system’s pilot for the lifestyle-change program took place at one ambulatory care site in Minocqua, Wisconsin.

MCHS charges participants of the lifestyle-change program $100 for one year, with a $50 refund incentive if the participant goals are met. The program includes a trained lifestyle coach to guide and encourage participants. This year-long course begins with 16–18 weekly sessions, followed by six monthly follow-up sessions. Participants have demonstrated positive healthy outcomes, while plans for program enhancements and expansion are underway.

Highlighting the numbers

It is important to collect supporting data to show the importance of a National DPP lifestyle-change program. This includes health insights and local demographic data, as well as outcomes from similar efforts. The team also looked at projected costs and returns, and presented the information to key stakeholders. Relying on the numbers can help make a case for a program for people with prediabetes.

“It’s about bringing back the data,” said Marilyn Hodgson, RN, system coordinator for diabetes and nutrition services at MCHS. “It’s something that’s going to have to go on [repeatedly] to continue proving to that group of administration and business that this is working.”

Engaging leadership and community

Diabetes prevention was an initiative whose implementation was accomplished by corralling the “right people at the right time,” said Hodgson. Speaking with specialists, community members and physicians determined the best program structure, helped launch a strategy and followed up on processes.

Together the team engaged organizational leaders, advocates, physicians and specialists after looking at the data concerning the health assessment of their patient demographic. The team identified a need for a program and persisted in making a successful lifestyle-change program a reality for MCHS.

At the close of the lifestyle-change program’s pilot program, decreased A1C and cholesterol levels were just part of the favorable outcomes demonstrated by participants.

“Being able to look at those outcomes is proving what a lot of us who work in medical care—in health—we all realize,” said Hodgson. “Prevention is necessary to keep our population healthier and have a better quality of life.