Rapid follow-up proven success for diabetes patients
02 Apr 2017By: Michelle Grove, NP specialist lead, SHMG glycemic management
Salem Health is building a Glycemic Management Team for both inpatient and outpatient services. A successful diabetes affinity test of change completed in 2016 reduced LOS and readmissions for diabetes, so Salem Health Medical Group is expanding expertise available to providers.
Several studies suggest that quick follow-up after hospital discharge is a key element in reducing readmission rates. The GMT will provide an on-campus clinic-based option for rapid follow-up for up to 60 days after hospital discharge. We’re waiting for licensed space in Bldg C., 4000, but will see discharged, high-risk patients with diabetes soon in CT Surgery space.
Many of you already know Sandra Bunn, CNS-PP, BC-ADM, CDE. Joining her is Michelle Grove,
ANP-C, BC-ADM, CDE, team lead for GMT. They are board-certified in Advanced Diabetes
Management and will provide diabetes medical management on inpatient/outpatient basis. They will see anyone with diabetes you’d like to refer, but will focus on patients with T1D, all insulin pump patients and those with T2D that have co-morbidities or other factors that make glucose control difficult to achieve. They are hoping to add a third NP to provide broader coverage. Referral can be placed under “MD Referral for CNS” in Epic.
Our diabetes educators include Delta Holderness, RN, BSN, CDE, who provides inpatient diabetes education two days a week and outpatient diabetes education in the CHEC. Valorie Hergenreter, RN, BSN, CDE, will join the team, providing inpatient diabetes education two days a week in her current role in the ED. Referral for diabetes education can be placed under “MD Referral for Diabetes Education” or nursing can place “Nursing Referral for Diabetes Education” in Epic.
The outpatient resource also includes RN navigators (outpatient community case managers) Kristen Lorenz, RN, BSN, CDE and Geneen Duxbury-Baggarley, RN, BSN, who work with high-risk patients with diabetes. They work their “magic” to network community resources for assistance with diabetes supplies, medications/insulin, food bank access, bus fare, etc., as well as diabetes education to meet health needs of people with diabetes.
The Glycemic Management Team is passionate about caring for patients and building collaborative relationships with physicians/NPs/PAs at Salem Health. Together, we strive to make a difference in patients’ lives while improving costs related to LOS and readmissions.