Sustainability Model for Diabetes Care in Rural Arizona

Objective: To establish and evaluate the infrastructure for a comprehensive and sustainable diabetes self-management program in partnership with local health care providers in a rural Arizonan community led by the Mt. Graham Regional Medical Center and Carondelet Health Network Diabetes Care Center in Tucson, AZ in order to offer a continuum of diabetes care.

Methods:  Evaluators are measuring the effectiveness of project activities by surveying key project leads via an evidence-based assessment tool using Planned Care Model components and measuring the level of system change achieved during the project period. 

Results: Interim reports show marked improvement in Mt. Graham's delivery system design, patient self-management support, community linkages, and healthcare delivery system organization.  Nearly all of the above areas have gone from being non-existent before the advent of this project to having in place a sustainable level of organized, consistent implementation of improved processes and patient care across the entire Mt. Graham patient care team. The use of telemedicine has augmented the delivery care system and leveraged partnership services through the training of rural health care providers in diabetes care and delivering parts of the diabetes education for patients via telemedicine. Areas of future focus include improving information systems and decision support to improve patient care and initiating a baseline evaluation of the newly formed Mt. Graham Diabetes Partnership.

Conclusion: By developing a local diabetes partnership, implementing components of the Planned Care Model, and partnering with a mentor hospital, a sustainable diabetes program can be developed in a rural community.