Addressing Social Determinants of Health in Diabetes Education
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Authors
Cabasa, Carisha
Issue Date
2024-07-06
Type
Manuscript
Language
Keywords
Social Determinants of Health , Quality Improvement , Diabetes Self-Management Education , Screening , Care Management , Change Management , Health Equity
Alternative Title
Abstract
Background: Social determinants of health (SDOH) play a significant role in patient outcomes, particularly among individuals with chronic conditions such as diabetes. This quality improvement (QI) project aimed to implement a new process to assess and address SDOH for patients receiving Diabetes Self-Management Education and Support (DSMES) services within a healthcare system in the Pacific Northwest region of the United States.
Methods: The project involved conducting staff training, development of resources and tools to support the new process, implementing social needs screenings for new patients receiving DSMES consultations, entering referral requests for care management for patients with positive screens in the electronic health record (EHR) and measuring the staffs’ attitudes towards change through pre- and post- implementation surveys.
Results: The QI project revealed critical insights into the prevalence and types of social needs among patients. The screening process identified that over 10% of the participants had significant social needs, highlighting a pervasive issue despite the small sample size and stringent inclusion criteria. Among the patients who screened positive, housing instability was the most prevalent, affecting 100% of these patients, followed by financial strain and food insecurity, each reported by 67%, and utility needs, which affected 33%. Out of the three patients who screened positive, only two referrals were forwarded to care management, indicating a breakdown in the process. The staff survey results indicated an increased understanding of the necessity of the change initiative, from 83% pre-implementation to 100% post-implementation. However, satisfaction with the change initiative decreased from 50% to 33%, and feelings of inclusion in the rollout dropped from 83% to 67%, indicating areas needing improvement in change management and staff engagement.
Conclusion: The findings of this QI project underscore the importance of addressing SDOH in patient care, particularly for those with chronic conditions like diabetes. While the project successfully identified and addressed critical social needs, it also highlighted the challenges in implementing such initiatives, including the need for better communication, workflow and EHR integration, and system-level support. To sustain the benefits of addressing SDOH, it is essential to focus on improving change management strategies, ensuring adequate resource allocation, and fostering a supportive environment for healthcare staff. By addressing these areas, healthcare organizations can enhance patient outcomes and create a more effective and inclusive approach to managing SDoH.
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Citation
Publisher
Creighton University
License
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University