Jeanie Schmidt Free Clinic
Herndon, VA
Kathy Gold, RN, MSN, CDE
SWOT
STRENGTH
WEAKNESS
OPPORTUNITY
THREAT
Patient Strengths
• Empower patients, not as isolated, encourages
sharing feelings and frustrations
• Information learned in class moving beyond patient to
family and friends
• Information shared by patients that may not have been
shared with HCP during typical visit
• Dig deeper into patient’s feelings
• Learned goal setting
• Built a trusting environment
• Breaks down ethnic barriers
• Decrease wait time
• Group support
• Increased motivation
Staff Strengths
• Support of clinical staff and
administration
• Everyone on the same page
• New skill development
• Motivating to staff
• Something new
• Attracted new staff
• Increase availability
Clinic Strengths
• Accommodate more patients
• Save physician time for complex patients
• Frees up time for more acute patients and high
risk patients to be seen by other providers
• HCP able to follow patient more closely
• Build a relationship with patient
• Group visits accommodate lower risk patients
that will benefit from intervention but condition
may not warrant extra attention
Clinic Weakness
• Organization may be thinking too small or don’t
share expanded vision
• Don’t see growth
• Cost
• Resource intensive
• Space required
• Requires a 2 hour block of time
• Sustainability - volunteer nature of team
Patient Weakness
•
•
•
•
•
•
•
•
•
•
Language barrier
Not appropriate for all patients
Hypertension and diabetes in one group
New terminology – goal setting
Cultural competence
Time offered, not available at night or weekend
What is “life after group visit?”
Culture
Gender
Recruitment understand what visits means
Staff Weakness
•
•
•
•
•
•
Resistance from some staff members
May not be something all staff can do
No NP’s to engage in process
Don’t like change
May require training
Not part of job description
Staff Opportunities
• Two new MD’s
• Identified successful training programs –
certificate for promotoro or health
educator
• Engage staff
– Share education among experts –
pharmacist, CDE, podiatrist, dietitian
• Develop job description for group visit
providers
Patient Opportunities
• Develop phase 2 –
– Diabetes group visit
– Hypertension group visit
•
•
•
•
•
•
•
•
Consider drop in group visits
Develop curriculum
Develop advanced curriculum
Created group education class for complex patients
Enroll more patients
Divide groups into cultural groups
Need entry and exit criteria
Spread visits from monthly to every 3 months
Staff Threats
•
•
•
•
•
•
•
•
•
•
Afraid to move out of comfort level
No back-up in case of emergency
HCP may be forced to participate
May not be in favor of concept
Change
Continuity
Sustainability
Lack time
Training of staff
Transition
Patient Threats
• Recruitment
– Patient identification
– Entry and exit criteria
• Too sick for group visit
• Transition
– Primary care to group visit
– Group visit to primary care
Questions?
Kathy Gold, RN, MSN, CDE
Diabetes Research and Wellness Foundation
800-941-4635
kathy@kathygoldcde.org
Virginia Diabetes Council
Virginia Diabetes Plan 2008-2017
www.virginiadiabetes.org