FirstHealth Program Wins National AHA Award for Diabetes Program

The American Hospital Association has recognized FirstHealth of the Carolinas with a 2014 AHA NOVA Award for a collaborative community effort to identify and educate people with diabetes.  The award will be presented July 22 at a ceremony during the Health Forum/AHA Leadership Summit in San Diego.
 
Recognized for its FirstReach program, FirstHealth is one of only five hospital systems being honored this year for demonstrating how working with partners in the community can improve the health and wellness of the people and patients that hospitals serve. The AHA NOVA awards program was established in 1993.
 
“We are pleased to honor this year’s AHA NOVA winners that through collaboration provide for the community through education, outreach and so much more to improve health and wellness,” says AHA President and CEO Rich Umbdenstock. “The hospitals leading these programs know the power of collaboration and the positive community health changes that can be achieved when organizations work together.”
 
“We are honored to receive this award from the American Hospital Association,” says David Kilarski, chief executive officer of FirstHealth of the Carolinas. “FirstHealth has a strong and long-lasting commitment to our community that goes beyond the walls of our hospital buildings. It is our goal to continue to serve our community with the resources they need to improve their health.”

FirstReach is offered through the Diabetes and Nutrition Education Center of Community Health Services, a department of FirstHealth that assesses community needs and responds to those needs through programs and services that extend beyond the hospital walls. The program is being recognized by the AHA for program results from 2007 to 2011, data that demonstrates the impact of addressing diabetes in a multidisciplinary approach in a rural setting.

The program originated in Montgomery County as a countywide, multidisciplinary diabetes outreach program pursuing three goals: to increase residents’ awareness of the signs and symptoms of diabetes and pre-diabetes; to implement early diagnosis through screenings and referrals; and to improve diabetes management and compliance through intensive education and coordination with primary care providers.

FirstReach was a data-driven initiative that resulted from a 2007 FirstHealth Community Health Needs Assessment, which noted that Montgomery County’s diabetes prevalence and mortality rates almost doubled state averages. The high mortality rate indicated that individuals were being diagnosed at later stages and were having greater complications from diabetes and that individuals were physically dying from diabetes.

At the time, FirstHealth did not offer any diabetes services in Montgomery County. As a result of the new information, however, Community Health Services took the initiative to acquire funds to begin the first phase of FirstReach, the screening component.

“FirstReach was developed in a slow, methodical manner in order to harness lessons learned, expand upon services offered and to collaborate with community partners,” says Roxanne Elliott, policy director, Community Health Services.

Starting with an initial small grant, FirstReach began conducting diabetes screenings at local banks, Walmart and senior centers as well as other community locations. With additional foundation funding and support from the state’s Office of Rural Health and the North Carolina Health and Wellness Trust Fund, the program began embedding certified diabetes educators in primary care practices to provide one-on-one diabetes education.

A voucher system developed through a partnership with area pharmacies allowed FirstReach to provide needed supplies and medications to identified patients.

The program’s final component involved the implementation of group medical visits that proved particularly effective. Eight to 10 patients gather at their primary care provider’s office for their monthly check-up with the provider “making the rounds,” examining each patient’s diabetes management indicators. Afterward, a certified diabetes educator gives a brief presentation on some aspect of diabetes self-management.

“With the group medical visits, the primary care provider isn’t repeating himself 10 times, since all patients will hear the same recommendations,” says Elliott.

“The group visits buffer costly no-show rates, which are common with underserved populations,” adds Melissa Herman, manager of FirstHealth’s Diabetes Program.

According to Daniel R. Barnes, D.O., president of the FirstHealth Physician Group, diabetes group visits significantly improve patient engagement in their disease and improved compliance.

“We had difficulty ‘graduating’ patients from the program, because they felt that they learned something new every visit,” he says. “Embedding diabetes educators in the primary care setting helps provide many patients with the necessary education and skill set to self-manage their diabetes.”

From 2007 to 2011, the diabetes mortality rate in Montgomery County dropped from 40.8 percent to 22.8 percent, while the prevalence rate increased from 16.1 percent to 20.9 percent - more individuals were diagnosed and the death rate dropped.

“FirstReach continues today with the addition of diabetes education telehealth services across the region, both for one-on-one consultations and group classes and through the addition of a depression screening for diabetic patients and a behavioral coaching approach,” says Herman. “Future initiatives will work to address pre-diabetes, in hopes of influencing the diabetes prevalence numbers.”

Also receiving 2014 NOVA awards are the Children’s Hospital Center for Pediatric Medicine Asthma Action Team, Greenville Health System – Greenville, S.C.; Let’s Go!, Maine Medical Center/MaineHealth – Portland, Maine; Hearts Beat Back: The Heart of New Ulm (HONU) Project, New Ulm Medical Center – New Ulm, Minn.; and Finney County Community Health Coalition, St. Catherine Hospital – Garden City, Kan.

More information on the awards and award winners is available at www.aha.org/NOVA.

About the AHA
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities.  The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks and other providers of care.  Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends.  For more information, visit the AHA website at www.aha.org.