GO! Diabetes :: News On The GO!

» Expand GO! Diabetes to more AAFP member practices throughout the United States building upon the lessons learned from prior years.

» Reach out to all family medicine residency training programs in the United States using the testimonials and success stories of you – our invaluable Change Agents and team members.

» Continue to collaborate with AAFP's METRIC and the Robert Graham Center for Policy Studies on Long Term Outcomes Resources and Permanent Practice Changes.

» Develop a program for GO! graduates to sustain and continue building momentum.

During the holidays, group dynamics are on display like a neighbor's festive light display. Whether it be at a Christmas party, family gathering or in our residency programs and private practices, being a part of a group causes us to interact with others and share a common identity in the moment. Rarely do we navigate through the holidays - much less life – flying solo.

We can all attest that support and encouragement through our affiliations help people grow. By forming a cohesive team, we perform better. By walking alongside our patients with compassion, they do better. By identifying ourselves with a cause and a creed we're proud of, we excel.

Could a therapeutic milieu provide the structure, support, safety, and trust to help people with diabetes build confidence, willpower and skill to better manage their disease? This year, some of our seasoned GO! Diabetes Change Agents put the question to the test.

Susan B. Riley, MN, APRN of the Family Health Care Center in Statesboro, GA targeted patients with an A1C of 7.5 or greater to attend a series of three group visits throughout the summer. Since there is no standardized model for group visits, Susan designed her own incorporating interactive group educational sessions with an individualized office visit during a two-hour visit for 22 patients. She discovered the messages delivered in the group visits were heard and acted upon with more conviction and staying power than the same messages communicated during regular office visits. As a result, all participating patients made significant changes in their A1C.

"We couldn't believe how motivated and excited our patients were to be a part of our group visits," said Susan. "All the patients had been followed and advised on many occasions how to improve their blood sugars, but they were finally able to accomplish a better number by participating in the group visits. In our practice, we witnessed history being made."

Setting the stage to enable bonding was a key to the group visits' success. "Our patients were energized and encouraged by hearing each other's stories," Susan added. "They knew they would be coming back together to celebrate each group member's success. We couldn't have manufactured that level of motivation on our own." Susan and her team were encouraged when they saw a leader emerge during the second group visit. "It was a patient we had tried to get more engaged in self- management for years."

Group visits:

Instill hope
Make patients feel they are not alone in their condition or issues
Impart information and alleviate anxiety
Promote modeling behavior and positive patient peer role models
Offer interpersonal and cognitive learning within a group setting
Provide group cohesiveness with peer support

Adapted from Group Visits (Shared Medical Appointments), 2010 American Academy of Family Physicians resources available online at www.aafp.org.

Dr. Lakshmi Gopireddy, a finalist in the resident category of the 2010 GO! Diabetes Poster Competition, touted her findings and results from her METRIC emphasis on group visits in her abstract and poster, "Implementation of Group Visits to Improve the Outcomes of Diabetes Targets."

Results gleaned from laboratory values and preventive care evaluations showed that not only did the diabetes group visits improve outcomes; it provided the residents and faculty a new and more satisfying way to interact with patients and their families. In addition to the Atlanta-based Morehouse School of Medicine Family Residency Program's already established multi-disciplinary flow sheets, Dr. Gopireddy discovered group visits were an efficient use of their resources and improved patient access to vital information to help manage patients' numbers.

"One of the keys to our group visit success was the ability to show the patients how to do things like reading food labels rather than just telling them to do it during a limited one-on-one visit," said Dr. Gopireddy. "Our patients were inspired and responded by telling family members and friends. We're getting busier at the clinic now."

The group milieu that happens the second Wednesday of each month has helped motivate positive behavior change in patients, one of the stated goals of the Morehouse family medicine residency program.

One way or another, isn't positive behavior change what we all desire for our patients? We want the positive changes to last beyond a season. We desire change that's evergreen.

The 2010 GO! Diabetes video series featuring the training workshops offered to Diabetes Change Agents has been reviewed and is acceptable for up to 5 prescribed credits by the AAFP.

This free CME series is available to all clinicians – so please share this important information with your colleagues.

Simply click on the below links to view the CME videos. At the completion of each video vignette, click on the Evaluate and Request CME link displayed beneath the video to complete the evaluation. Once complete, fax your evaluation to the Georgia Academy of Family Physicians' office at(404) 321-7450 to receive your CME completion certificate.

Dashing through the day,
Now METRIC's underway
O'er the data we go,
Laughing all the way
Happy patients sing
"I won't give up the fight,"
What fun it is to call and sing
"Your sugars are all right," oh -
A1C, A1C
Under 7.5
O what fun it is to see
Practice changes changing lives!