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W W W. D I A B E T E S H E A LT H E Q U I T Y. O R G

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W W W. D I A B E T E S H E A LT H E Q U I T Y. O R GW W W. D I A B E T E S H E A LT H E Q U I T Y. O R G

TYING IT ALL TOGETHER – THE 3-ELEMENT MODEL REALIZED

“ A Virtual Exploration of the 3-Element Approach for Achieving Diabetes Health Equity”


TYING IT ALL TOGETHER – THE 3-ELEMENT MODEL REALIZED

“ A Virtual Exploration of the 3-Element Approach for Achieving Diabetes Health Equity”


TYING IT ALL TOGETHER IN A RAPID-CYCLE IMPROVEMENT PROCESS

How Do We Tie it All Together? Can we do rapid-cycle feedback on outcomes and continuously improve interventions in each domain and in the spaces in-between the patient and the practice, or between the practice and the community or between the hospital and home, with a health equity coalition all working together to keep improving connections and processes and outcomes until we eliminate disparities?

Clinic (PCMH)

Home & Community

Outcomes (Hospital Bed-

Days, Disability, Death)

1 2

3

4

576


MODERATOR

GEORGE RUST, MD, MPHCO-DIRECTOR,

NATIONAL CENTER FOR PRIMARY CARE


Tying It All Together – The 3-Element Model RealizedWhat: Serving as the best practice, the Southcentral Foundation and the Camden Coalition will share their parellel experiences and success stores in using the3-Element Model of integrating clinic, community and data driven interventionsTo change the health system and improve the overall health of two underserved cities.


STEVEN KAUFMAN, MDSTAFF ENDOCRINOLOGIST,

CAMDEN COALITION OF HEALTHCARE PROVIDERS

DEPUTY MEDICAL DIRECTOR, URBAN HEALTH INSTITUTE


Camden CityMedian Family Income: $29,11836% below Federal Poverty Level48% Black, 47% Hispanic

Camden CountyMedian Family Income: $57,42911% below the Federal Poverty Level21% Black, 14% Hispanic

NEED FOR LOCAL DATA


CAMDEN HIE


CAMDEN RESIDENTS ARE TWICE AS LIKELY TO USE THE EMERGENCY DEPARTMENT


COST ARE CONCENTRATED BY GEOGRAPHY AS WELL

6% of city blocks account for 18% of the patients, 27% of the visits, and 37% of receipts.

Several buildings in the city are responsible for between $1 and $3 million in hospital costs each year.


STEVE TIERNEY, MD, CMIOMEDICAL DIRECTOR OF QUALITY

IMPROVEMENT SOUTHCENTRAL FOUNDATION


Alaska Native People Shaping Health Care

Southcentral FoundationNuka System of Care

New Directions in the Assessment of Community Health and Organizational Redesign

Copyright © 2011 Southcentral Foundation. All Rights Reserved.NOTICE: Unless otherwise indicated, this work represents copyrighted material protected by United States and international law. This work may not be used, reproduced, downloaded, disseminated, published, transferred or transmitted, in whole or in part, in any form or by any means, electronic or mechanical, including photocopying, recording or information storage and retrieval, except with the express written permission of the publisher. This work may not be edited, altered, or otherwise modified, in whole or in part, except with the express written permission of the publisher.


APPROACH TO CHANGE IS INFLUENCED BY PROSPECTIVE

Copyright © 2011 Southcentral Foundation. All Rights Reserved.


CHANGING PROSPECTIVE CAN ALTER APPROACHTO CHANGE



INTERACTIVE CONDITION CENTERED ACTION LISTS FOR ALL METRICS

Fictitious Customer Owner Info


WHAT DOES THIS MAKE YOU WANT TO KNOW?


CDR PROFILE



DISCUSSION

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COMMERCIAL BREAK&

ANNOUNCENMENTS


QUESTIONS FROM THE AUDIENCE

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THANK YOU FOR PARTICIPATING

Please assist us by completing the post survey for this training. The link is located in the chat box to the bottom right of your screen.

This webinar series is funded by Bristol-Myers Squibb Foundation Partnership for Diabetes Health Equity.

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