Developing Clinical Leaders in Primary Care: The US Air Force Diabetes Champion Course

Presentation Number: SH04-4
Date of Presentation: April 3rd, 2017

Darrick James Beckman*, Irene Folaron, Mark Windell True, Jana Wardian, Nina A Watson, Connie C Morrow and Tom J Sauerwein
San Antonio Military Medical Center, San Antonio, TX

Abstract

BACKGROUND:

There are over 150K patients (active duty, family members, and retired) with diabetes treated in over 400 worldwide Military Health System (MHS) clinics. Endocrinologists are located at only 15 MHS medical centers; therefore, the majority of diabetes care is delivered in primary care clinics. The US Air Force Diabetes Center of Excellence, whose mission is to promote excellent diabetes care and prevention across the MHS, designed the 3-day Diabetes Champion Course (DCC) to develop primary care leaders to effectively deliver diabetes care. The DCC includes comprehensive diabetes education on guidelines, resources, and hands-on training in a team-based format of which there have been 9 iterations with about 400 participants. We hypothesized that the DCC improved participants’ knowledge, skills, and intention to change clinical practice.

METHODS:

At the last course with 94 participants, we conducted a 17-question pre- and post-course survey to assess the effect of the course.

RESULTS:

Knowledge based questions showed improvement in basic familiarity with insulin pumps (p<0.01), knowledge behaviors to prevent macrovascular complications (p<0.01), and knowledge of cost-effective methods of utilizing self-monitored blood glucose levels (p<0.01). The majority of providers (97%) reported acquiring new knowledge about initiating and titrating insulin despite 89.5% feeling confident prior to the course. Skills based questions showed improvement in ability to demonstrate glucose meters to patients (p<0.01) and ability to perform a comprehensive foot exam (p=0.01). Intention to change clinical practice was demonstrated by 87.8% of participants reported a need to revise current preoperative processes for patients with diabetes; participants’ likelihood to use online resources presented at the DCC significantly increased (p<0.01); and an improved concept of team-based care noted by an increase in perceived responsibility of technicians (p<0.01), nurses (p=0.01), and disease managers (p=0.02) to ensure a foot exam is performed.

CONCLUSION:

The DCC provides an effective way to communicate comprehensive diabetes guidelines to the primary care teams, while empowering Diabetes Champions strategically throughout the MHS. Knowledge, skills, and intention to change clinical practice increased through participation in this 3-day course. More follow up is needed to see the extent by which patient care may be positively affected.

 

Nothing to Disclose: DJB, IF, MWT, JW, NAW, CCM, TJS