Criteria used to determine the 2006 Programs of Excellence:
DCOM was looking for innovative multi-disciplinary efforts within the Commonwealth whose goal is the
prevention, education, and management of diabetes in children and/or adults.
Archives:
Below are the 2006 recognized Programs of Excellence:
The Family Health Center of Worcester's Diabetes Care Program was designed to improve the quality of
care for patients with diabetes. Based on the Chronic Care Model, which is a model of healthcare
delivery promoted by the U.S. Department of Health and Human Services, the program works in
partnership with patients to assist them in learning how to manage their chronic illness. A physician, a
nurse who is extensively trained in diabetes management, and a patient advocate work together with
each patient on providing medical care, education, and support. Family Health Center patients have
access to the local YWCA through memberships purchased with donations raised by Diabetes Physician
Champion, Dr. Lucy Candib. Within the first 21 months of the program, 973 patients began exercising at
the Y, and they have made dramatic improvements in gaining control over their diabetes.
By embedding a nurse practitioner in a traditional mental health setting, the Health Access and
Integration Program in Salem offers convenient diabetes-related screening, education, treatment, and
coordination of care to an often stigmatized and underserved population of individuals who are
mentally ill. The program provides "one stop shopping" for a population that is often unable to get the
medical care they need. Seriously and persistently mentally ill patients access medical care in a setting
in which they are accustomed to receiving treatment. Psychiatric patients as a group are at higher risk
for medical problems than the general population. The psychotropic medications that cause weight gain
are of special concern because of the direct relationship between overweight and obesity and the
development of Type 2 diabetes. The nurse practitioner works closely with psychiatrists and
caseworkers who can accompany their patients to medical appointments if the patient is anxious, and
can support goals related to nutrition, exercise, and foot care. The nurse practitioner is dually trained
as a psychiatric nurse and is sensitive to the extra needs of patients with mental illness. This program
has been so successful that, with funding from the National Institute for Disability and Rehabilitation,
Boston University is studying it over a three-year period. The program receives funding from the Blue
Cross Blue Shield of Massachusetts Foundation and its parent corporation Northeast Health System,
Inc. and Health & Education Services, Inc.
Lowell Community Health Center's (LCHC) Diabetes Case Management Model is designed to meet the
needs of its diverse patient community, which is largely Cambodian, Brazilian, African, and Latino. In
addition to medical care, patients with diabetes are given access to linguistically and culturally
appropriate education programs and peer support groups, which are often held in familiar community
settings, as well as exercise classes, nutrition education, and stress-reduction sessions. LCHC has
seen its patients' HbA1c levels improve dramatically. Dorcas Grigg-Saito, CEO of LCHC, credits its
multicultural, multi-disciplinary team approach and partnerships with organizations like the Lowell
Senior Center, the Massachusetts Alliance for Portuguese Speakers, the Cambodian Mutual Assistance
Association, and the Cambodian Community Health 2010 Program with creating a comprehensive
program that is making a great difference in the health and lives of its patients.
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| Programs of Excellence |
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| Other Years Programs of Excellence |