Alliance to Reduce Disparities in Diabetes

The Diabetes Equity Project (Dallas, TX)

THE PROGRAM:

The Diabetes Equity Project (DEP) has leveraged the extensive community partnership among Baylor Health Care System (BHCS), the BHCS Office of Health Equity, the HealthTexas Provider Network Office of Community Health Improvement, Project Access Dallas, Genesis Medical Foundation, Dallas-area charitable clinics, and Blue Cross Blue Shield of Texas to reduce disparities in diabetes care for underserved people with diabetes in Dallas County, Texas.

THE GOALS:

As a not-for-profit health care provider in north Texas, Baylor Health Care System has made a system-wide commitment to improving equity in health care access, health care delivery and health outcomes. This commitment is integrated with its overall quality improvement strategy to providing STEEEP care (care that is Safe, Timely, Effective, Equitable, Efficient and Patient-centered).

  • The Diabetes Equity Project extends the BHCS commitment to health equity by working to improve both access to and quality of care delivered to low-income, minority, uninsured and underserved people with diabetes who reside in Dallas County,Texas.

THE APPROACH:

  • The DEP will utilize a multi-faceted approach that includes interventions at the physician, patient and system levels to improve diabetes health equity in Dallas County.
  • Integral components of the DEP include a community-based disease management program. This component will be led by certified community health workers who are strategically deployed within five Dallas-area charitable clinics, providing patients the opportunity to acquire knowledge, self-care practices and behaviors required for the effective management of their diabetes.
  • Cross-cultural competency education programs will be delivered through continuing medical education (CME) events targeted at primary care physicians and staff who volunteer to care for uninsured people with diabetes. These programs provide physicians the opportunity to attain cultural knowledge and care delivery strategies to promote improved health outcomes for people with diabetes in their practices.
  • The implementation of an electronic diabetes registry will foster improved multidisciplinary communication among health care providers in the DEP as well as assist in evaluating the health outcomes of patients enrolled in the program.

PROGRESS:

  • Over 1200 patients have enrolled. Patient satisfaction mean scores are 99%.
  • Preliminary analysis of Year 1 results revealed a statistically significant change in mean HbA1c levels one year post-baseline. The mean HbA1c value for patients at baseline was 8.7%. Mean HbA1c value one year post-baseline dropped to 7.4%.
  • A health care provider CME training program entitled “Diabetes, Disparities, Demographics,” has been delivered to 24 clinicians in the Dallas County area. A Health Literacy CME was conducted by the Literacy Coalition of Austin in which 40 providers attended and was well received. There are plans to expand the provider audiences for this CME in the coming year.
  • Two new Community Health Worker job codes were approved by the BHCS Human Resources, thereby creating a system-wide CHW career path, which sets the stage for future CHW workforces within Baylor.
  • The retinal eye screening initiative was so successful that Project Access Dallas, a key partner for DEP, began outsourcing diabetic retinal scans as an alternative to formal ophthalmology specialty
    consultations, allowing better utilization of ophthalmology providers for treatment of pathology rather than screening.
  • Baylor Community Care and its BHCS senior leadership Governance Council, has funded an additional Diabetes Health Promoter position within a new Baylor Community Care clinic in Fort Worth.

Affiliated Sites:

For more information on the Diabetes Equity Project, please contact Christine Snead at Christine.Snead@baylorhealth.edu