Grass-Roots QI

Advocate Health Centers in Chicago regard the emotional element of diabetes as a high priority in successful treatment. The day that patients receive the diagnosis, doctors send them to Mildred Blanchard, RN, nurse visit coordinator. "It’s a very stressful time," she observes. "Patients usually feel they’re the only ones who have the problem. Somehow, when a nurse explains insulin injections, they can accept it better. I have time to hear their emotional concerns and to answer their questions."

-Solutions

Blanchard holds 10 90-minute group visits or classes each month. Attendance is voluntary and anybody is invited. "People come out in droves," she notes. Attend-ance averages 15 to 20 regulars, with most in their 60s and 70s. Blanchard introduces current diabetes management techniques, answers questions, and does foot exams. Members share information and emotional support. Ninety-eight percent routinely monitor their blood sugars. Classes sometimes run an extra hour, until all questions are answered. Instead of touting the benefit of exercise, Blanchard shows them. On a recent 15-minute walk in a shopping mall, one lady’s blood sugar dropped from high to normal. "Patients can hardly believe the value of that little bit of exercise!" At the class members’ request, Blanchard is looking into water exercise opportunities.

-RESULTS

Eighteen months into the program, before-and-after data look like this: Number of participants who receive the following on a regular schedule:

• Hemoglobin A1C tests — 93% (63% pre-program)

• Blood pressure checks — 98% (96% pre-program)

• Foot exams — 73% (37% pre-program)

• Eye exams — 63% (54% pre-program)

-Keys to success

"I emphasize to people that even though they have diabetes, there’s no reason they can’t enjoy good health if they take care of themselves," explains Blanchard.

-Contact

Mildred Blanchard, RN, Nurse Visit Coordinator, Advocate Beverly Center, 9831 S. Western Ave., Chicago, IL 60643. Telephone: (773) 881-5665.