1. Getting Started
Defining Program Goals
It can be helpful to spend some time thinking about what you want to accomplish by implementing diabetes group visits. Having a clear purpose can guide your planning and communication about your program. Which of the potential benefits are most relevant, timely, and important? How do diabetes group visits align with the values and priorities of your health center? For example, is your health center focused on implementing team-based care, taking part in a diabetes quality improvement initiative, pursuing patient-centered medical home designation, or aiming to improve outcomes among patients with multiple chronic conditions? Consider how group visits can support your organization’s goals.
Preliminary Decision-Making
- Target population. Decide which patients the group visits will be open to. Do you want to include any patient with diabetes who is interested or focus on a specific population (e.g., A1C>9%, Spanish-speaking, comorbidities)?
- Anticipated start date. Review the timeline for planning and implementing group visits. Decide when you would like to have your first group visit, taking into consideration the preparation time needed.
- Mode of delivery. Group visits can be done in-person or virtually. The mode of delivery should be determined so you can make sure your team includes the necessary staff and plan accordingly.
- Outcomes of interest. What are the main changes you want to see as a result of your program (e.g., lower A1C, better medication adherence, greater satisfaction)? How will you know if your program has had an effect?
Engaging Stakeholders
Successful implementation of your program hinges on the support of others at your organization. Include stakeholders early in the process and maintain regular communication. Some people will not be familiar with the group visit model of care so be prepared to educate them. How would you describe group visits in one sentence? What resources might be helpful to share with stakeholders?
Steps for getting buy-in from stakeholders:
- Identify what motivates stakeholders.
- Create a culture of trust by being clear about tasks and potential barriers.
- Clarify expectations from stakeholders and get input.
- Provide consistency in messaging.
- Report to stakeholders on progress throughout program planning and implementation.
- After the program, share outcomes and lessons learned and thank stakeholders for their involvement.
Potential Roadblocks
A provider is reluctant to refer patients because they do not believe in the group visit model. How do you address the concerns the provider has and engage them in supporting group visits?
- Find out more about why they don’t believe group visits will work. Consider if there are any patient stories or research studies you could share to address their specific concerns.
- Ask what their biggest barriers or frustrations are with caring for patients with diabetes. Think about ways group visits might help alleviate any of problems.
- Suggest the provider refer one or two patients as a trial to see how it goes. Then they can decide whether to refer more patients.
- What else could you try?
Your health center experiences a change in leadership. The new director is not familiar with group visits and wants your team to spend less time on the program. How could you help the director understand the program and justify the effort your team is putting in?
- Find out what the director’s priorities and goals are for your health center. Explain how group visits align with the mission of the organization and its current goals and priorities.
- Present a business case for the program showing that personnel effort required for planning and implementation could be recovered by improved efficiency, quality, and clinical outcomes.
- Invite the director to join a group visit session to see firsthand how much patients enjoy and benefit from the program.
- What else could you try?