May 15, 2023
T1D Exchange Quality Improvement Collaborative
May Strategy Session 2023
Diabetes Distress working group
Link to Recording
Discussion Questions
- Start with open discussion of interested PIs.
- Each group to select 2 volunteer leads (one adult and one peds)
- Choose deliverables, SMART aims, and timelines. Each group can decide
- Plan interventions that tie to the KDD
- Plan for organization and visualization of data (e.g. run charts)
- Progress report due by the November meeting
Minutes
- Participants
- Dr. Devin Steenkamp
- Dr. Liz Mann
- Dr. Mary Scott
- Dr. Caleb Schmid
- Dr. Anna Neyman (Dr. Tamara Hannon to take over)
- Dr. Alissa Roberts
- Ann Mungmode
- Emma Ospelt
- Previous experience
- Seattle Children’s has used the Paid-T Diabetes distress tool (Seattle)
- Alissa is happy to share their past publications
- Diabetes Distress – collaborate to develop a structured implementation program and model to address diabetes distress in routine clinical practice
- Boston Medical Center invited Larry Fisher to facilitate a session on diabetes distress scale
- What is practical in a clinical space and supporting diabetologists in asking these important questions
- How do we respond to screening? Composite score, or individual questions?
- The lessons we learn about how to do this in practice would be great to share out
- How to make DDS transformed from a research tool to a practical clinical tool
- Be careful with mental health diagnoses; there are implications to a diagnosis (employment)
- OHSU has an ICD-10 code that they use for psychological events in T1D
- We want those people to receive the care they need to improve psychologically
- Leading this workgroup
- Liz is interested, unsure about bandwidth
- Alissa would be happy to doing together and supporting wherever possible
- If we only wanted one pediatric PI
- T1DX-QI will support with administrative tasks (like scheduling meetings)
- Meeting frequency
- Monthly would be good
- Would be helpful to have the next meeting soon to keep momentum going
- Get an email train started
- Monday afternoons work well
- Plan for next meeting
- Suggestion that every member share
- What is your current process, what tools do you use
- Liz can share out a ‘survey’ to enhance our discussion next time
- 10 minutes sharing
Potential outcomes/deliverables
- Identify preferred distress tools to use (in peds and adults)
- Coding for providers to use
- Processes for clinical If a patient scores highly in total or in specific areas
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- If not feeling listened to, trigger something to improve communication between provider and patients
- It was easier to implement diabetes distress compared to PHQ-9 because not the same kind of acuity (suicidal ideation) – difficult hurdle due to the safety risk
- The measures (building into EHR) may be one of the most challenging
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- May need to consider paper options
- Our recommendations on distress tools for members of the T1DX-QI
- How to capture teens who are not distressed but parents are (and similarly, adult patients with partners)
- How to measure the impact of diabetes distress on families as opposed to individuals
- There are different types of distress
- Differing interventions
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- Psychology
- Social workers
- Support
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