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Part Two: Questions in the Field

Due Date: Self directed assignment to be completed during the first two weeks of the clerkship.

The following assignment will allow you to explore diabetes quality care initiatives at your real life clinical sites on your primary care clerkship. The field research here will shape and contribute to your answers to PART THREE of the assignment. You should approach your clinical site director, medical director, physicians and nurse practitioners, nurses, patients, social workers, community leaders, nutritionists, podiatrists, administrators as appropriate. Feel free to look up resources and initiatives on the internet – or perform a literature search. Some of the questions asked are based on recommendations from Institute For Healthcare Improvement.

The Institute For Healthcare Improvement (IHI)
Eight knowledge domains for the improvement of health care:

1. Customer/beneficiary knowledge

  • Identifying person, persons, or groups for whom health care is provided and assessing their needs and preferences. This domain covers the relationship of the health care provided to those needs and preferences.

2. Health care as process/system

  • The interdependent people (patients, families, eligible populations, and caregivers), procedures, activities, and technologies of health care-giving that come together to meet the need(s) of individuals and communities.

3. Variation and measurement

  • Using measurement to understand the variation of performance in processes and systems of work and to improve the design and redesign of health care.

4. Leading, following and making changes in health care

  • The methods and skills for making change in complex organizations, the general and strategic management of people and the health care work they do (financing, information technology, and daily health care-giving).

5. Collaboration

  • The knowledge, methods, and skills needed to work effectively in groups, and understand and value the perspectives and responsibilities of others. This domain includes the capacity to foster collaboration in others.

6. Developing new, locally useful knowledge

  • Recognizing the need for new knowledge in personal daily health professional practice. This domain includes the skill to develop new knowledge through empiric testing.

7. Social context and accountability

  • An understanding of the social contexts (local, regional, national, and global) of health care, including health care financing.

8. Professional subject matter

  • The health professional knowledge appropriate for a specific discipline and the ability to apply and connect domains 1–7. This domain includes core competencies published by professional boards, accrediting organizations, and other certifying entities.
 

Student Field Research Questionnaire

If your site has no ongoing diabetes quality improvement projects, you can substitute information about another chronic disease CQI project that they may be using:

Question 1: What are the general demographics of the patients at your clinic site in terms of age, sex, race, and cultural ethnicity? What is the payer mix (self-pay, Medicaid, Medicare, private insurance, other) of the practice?

Question 2: What is the system and process of care for the diabetic patients seen in your practice site? What is the patient flow like in a visit?

Question 3: From the perspective of a diabetic patient, what is the process of care during a clinical visit? How do they experience the visit? How would they prefer to learn more about diabetes care? What would they like to ask about if they could?

Question 4: Are there diabetes CQI projects at your site? Are there particular parameters they are examining? What have they found? If there is not a CQI project for diabetes, are there CQI project for other chronic diseases?

Question 5: What electronic resources are available at your clinic site to assist in caring for patients with diabetes? Are there electronic medical records that have the capacity to do CQI or clinical research searches?

Question 6: What interventions are underway, if any, to improve diabetes care at your site? If there is not one for diabetes, are there interventions for improving outcomes for other diseases? Are interventions targeting changes in the system, patient education, or provider education?

Question 7: What multidisciplinary teams exist at your site if any? Who is involved in CQI at your practice and in what capacity? How does the multidisciplinary team communicate and collaborate with each other on an ongoing basis?

Question 8: Are there local community or state initiatives to improve diabetes outcomes? What national initiatives are being implemented at your site?

Question 9: Are there any patient education interventions at your site? Are they culturally responsive? Are they language specific? What is the health literacy level of written education materials on diabetes that is handed to patients?

Question 10: If you had to choose one parameter on diabetes care at your site, what recommended changes would you make in clinical processes, patient education, provider education, etc?

Print version of this Student Field Research Questionnaire (pdf)

Submit your Questionnaire to complete this assignment
(Cybertown Family Health Center - Assignment #2)

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