September 23, 2023

Sept 22, 2023 | Diabetes Distress Group Meeting Minutes

Attendees: Casey Berman, Don Buckingham, Rebecca Butler, Haley Centola, Michelle Coulter, Jenny Iyengar, Manu Kamboj, Liz Mann, Emma Ospelt, Nicole Rioles, Caleb Schmid, Devin Steenkamp, Heather Yardley

Notes

• Nationwide (Manu and Heather). Made KDD. Working with paper now. Trying to move to ipad. Front desk handing- screening 12-18 y/o. Given to rooming nurse. Heather scores. Debriefs with families and clinician. Limit when psychologist is available. May spread to other sessions when capacity avaiable. Goal: make a Pareto chart to identify/visualize what is significant. Distress more context for what is causing depression- better to tailor intervention ideas. Coordinating with social work. Overlapping population: distress, transition, depression. Nationwide is using pre-visit planning- standardized in system to plan screening needs.- Use a remind me note to catch them in a year.
• Rebecca Butler (TCH)- used birthday quarters to ID when to do PHQ9 screening. Asked about inpatient use.
• Caleb Schmid OHSU- trying to strategize. Few are piloting. T1DDS (30 pt scale) feels cumbersome. (Staffing issues) Trying to build flow sheet to put into Epic
• Devin Steenkamp- Boston Medical Center shared a general overview of the purpose of the group and the work to date. BMC tested implementing T1DDS and T2DDS in clinical space. BMC is doing it without a psychologist. Just trying to incorporate into flow. 20 min appt. are challenging. 400 visits daily- it’s challenging. Have only done 10-12. Doing with study coordinator. Goal of trying to get to 200 complete by end of year to have some preliminary analysis. Goal- make a case for staffing resources for psychology. Just identifying- not providing resources to patients yet.
• Jenny Iyengar University of Michigan, Adults: part time social worker now, tied to location. Issues with support on adult side. Social worker doing PAID now- wants to switch over to T1DDS. Results shared from pre-covid. Score high were less likely to do 3 visits per year transitioning to adult care
• Seattle Alissa Roberts- pairing depression and distress screening- same process. Use PAID T. Scanning on tablet (Tonic) in rooming process. Rolled out in 2018. 22% had distress. Built into Epic Mychart. MA manually puts it on Mychart to patient, not parent. Most do at the beginning of visit, not before. Not set up as a BPA now. Psychologist is embedded to address at the main clinic. Goal: extend to regional clinics. MA leadership role was eliminated, so staffing challenges. Screening 13 up now. Want to change to ages 12 up. Future goal of screening 8 and up.
• T1DX (Nicole) There are Diabetes Distress measures in the Smartsheet measures. We ask clinics to report any/all Diabetes Distress tracking in Smartsheet in the coming months. Data Science Committee is setting a goal to add Diabetes Distress elements into the Data Spec over the next 6 months so that mapped clinics that have been documenting diabetes distress will be able to report data. We ask clinics that have been able to integrate DDS into EMR to share screenshots to help other clinics incorporate into their own EMR systems.

Action items

• Next meeting : Friday October 27^th 12-1 (EST). Each clinic that attends next month will be invited to present (5 minutes each) on their most recent diabetes distress PDSA cycle.
• We will use time during lunch hour at learning session to discuss Diabetes Distress in person and there will be a 15 min report out for the work group during 11/15 learning session.
• Clinics should set goals to track diabetes distress and report patients screened (numerator) and patients eligible for screening (denominator) in Smartsheet. If you don’t know what Smartsheet is, talk with your PI or ask T1DX for those details or ask Nicole or your QI coach.

Link to Recording: https://youtu.be/4yu0K41ULyw