Diabetes to Go Inpatient
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 9/29/2018 |
| Start Date: | April 1, 2016 |
| End Date: | March 31, 2019 |
This is a study to examine if it is possible to fit a diabetes education program into the
workflow of hospital nursing units for delivery at the bedside to individual diabetes
patients and, if so, the best design for implementation without increasing the burden of work
of staff on the nursing unit.
The study will refine and test the Diabetes 2 Go education program content and processes to
establish Diabetes 2 Go program toolkit for use in additional hospital settings and
hospitals.
workflow of hospital nursing units for delivery at the bedside to individual diabetes
patients and, if so, the best design for implementation without increasing the burden of work
of staff on the nursing unit.
The study will refine and test the Diabetes 2 Go education program content and processes to
establish Diabetes 2 Go program toolkit for use in additional hospital settings and
hospitals.
The investigators seek to determine the feasibility of integrating the Diabetes To Go
program's sustainability into ongoing hospital nursing unit processes for patient education
and discharge planning. If successful, preliminary data generated will be used to develop a
randomized controlled trial which will further assess program outcomes, including clinical
and economic measures and potential for widespread dissemination.
The objectives of the present R34 Diabetes To Go Inpatient proposal are to refine the
Diabetes To Go program content based on user feedback and experience, as well as to design
and develop processes to enhance the feasibility of integrated implementation within usual
nursing unit workflow within a large health system. A mixed-methods approach is used to
leverage implementation science frameworks and human factors principles to make DM survival
skills education and discharge support more accessible, interactive and engaging for
patients. The long-term goal of this research is to optimize scalable and sustainable
solutions for DSME and for DM-related discharge support. This personalized approach leverages
e-health technologies to pursue the following Specific Aims:
Aim 1: To refine and optimize the Diabetes To Go program content and implementation
processes.
This will be achieved by applying user-centered interface design principles, content
development in partnership with patients and providers, detailed process mapping for program
integration into existing processes and workflow, and integrating mobile and e-health
technology to support care transitions. The Practical, Robust, Implementation and
Sustainability Model will guide implementation planning and evaluation.
Hypothesis 1. Diabetes To Go: will be optimized for patient and provider usability and
integration into nursing unit workflow; will enhance patient self-care knowledge and skills;
and will support the discharge transition process.
Aim 2: To conduct iterative rapid-cycle usability testing of the enhanced Diabetes To Go
program content and processes and establish a Diabetes To Go program toolkit for widespread
implementation.
This will be achieved by a series of intervention-evaluation cycles of field testing,
refinement, retesting of the Diabetes To Go program and evaluation through: direct
observation; patient, provider and system leadership stakeholder interviews and focus groups;
and evaluation of changes in early patient outcomes.
Hypothesis 2. The Diabetes To Go program will be perceived favorably by stakeholders yielding
a high-quality toolkit for implementation and delivery of the program for further evaluation
and testing.
Preliminary data gathered during this study will be used to design an R18 pragmatic trial in
response to PAR 15-157 which will examine outcomes of implementation of the Diabetes To Go
program when delivered on hospital nursing units to adult patients with diabetes across
hospitals and health systems. The model has the potential to cause a paradigm shift in
sustainable and generalizable approaches for delivery of patient-centered education and
medication adherence and discharge transition support in the hospital
program's sustainability into ongoing hospital nursing unit processes for patient education
and discharge planning. If successful, preliminary data generated will be used to develop a
randomized controlled trial which will further assess program outcomes, including clinical
and economic measures and potential for widespread dissemination.
The objectives of the present R34 Diabetes To Go Inpatient proposal are to refine the
Diabetes To Go program content based on user feedback and experience, as well as to design
and develop processes to enhance the feasibility of integrated implementation within usual
nursing unit workflow within a large health system. A mixed-methods approach is used to
leverage implementation science frameworks and human factors principles to make DM survival
skills education and discharge support more accessible, interactive and engaging for
patients. The long-term goal of this research is to optimize scalable and sustainable
solutions for DSME and for DM-related discharge support. This personalized approach leverages
e-health technologies to pursue the following Specific Aims:
Aim 1: To refine and optimize the Diabetes To Go program content and implementation
processes.
This will be achieved by applying user-centered interface design principles, content
development in partnership with patients and providers, detailed process mapping for program
integration into existing processes and workflow, and integrating mobile and e-health
technology to support care transitions. The Practical, Robust, Implementation and
Sustainability Model will guide implementation planning and evaluation.
Hypothesis 1. Diabetes To Go: will be optimized for patient and provider usability and
integration into nursing unit workflow; will enhance patient self-care knowledge and skills;
and will support the discharge transition process.
Aim 2: To conduct iterative rapid-cycle usability testing of the enhanced Diabetes To Go
program content and processes and establish a Diabetes To Go program toolkit for widespread
implementation.
This will be achieved by a series of intervention-evaluation cycles of field testing,
refinement, retesting of the Diabetes To Go program and evaluation through: direct
observation; patient, provider and system leadership stakeholder interviews and focus groups;
and evaluation of changes in early patient outcomes.
Hypothesis 2. The Diabetes To Go program will be perceived favorably by stakeholders yielding
a high-quality toolkit for implementation and delivery of the program for further evaluation
and testing.
Preliminary data gathered during this study will be used to design an R18 pragmatic trial in
response to PAR 15-157 which will examine outcomes of implementation of the Diabetes To Go
program when delivered on hospital nursing units to adult patients with diabetes across
hospitals and health systems. The model has the potential to cause a paradigm shift in
sustainable and generalizable approaches for delivery of patient-centered education and
medication adherence and discharge transition support in the hospital
Inclusion Criteria:
1. Age > 18 yrs (lower limit of age for admission to MWHC adult units
2. English speaking (Diabetes To Go content is currently only available in English);
3. Diagnosis of diabetes mellitus (ICD9 250.xx/ICD-10-CM E08-E11) documented in the EMR
4. Admitted to one of the inpatient units (non-critical care adult medicine nursing
units, including 1 psychiatry unit) where the study is being conducted
5. Willing and able to participate in the program.
Exclusion criteria:
1. Age < 18 years (MWHC does not admit minors to its Medicine units and Diabetes To Go
content has been prepared for adult learners)
2. Pregnancy or anticipated conception within 3 mos (Diabetes To Go content does not
address gestational diabetes or diabetes in pregnancy where management and glycemic
targets differ considerably from those for non-pregnant adults );
3. Admission to an intensive-care unit, diabetic ketoacidosis, hyperglycemic hyperosmolar
state - conditions in which the acuity level would likely preclude participation in
DSME;
4. Patient declines participation in the education program for any reason; and any
medical condition or cognitive dysfunction that, in the opinion of unit staff, would
preclude participation in the education program.
Exclusion Criteria:
We found this trial at
1
site
Washington, District of Columbia
Principal Investigator: Michelle F Magee, MD, MBBCh
Phone: 202-877-2383
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