GME Patient Safety Quality and Innovation Symposium

Gestational diabetes mellitus (GDM) that affects 2-10% of pregnancies in the United States is a harbinger of future GDM, type 2 Diabetes Mellitus, Hypertension, and cardiovascular disease. This risk can be significantly reduced with weight loss. Lifestyle changes are often intensive processes that require involvement in a program with skilled and certified educators such as Center for disease control and prevention’s (CDC) National Diabetes Prevention Program (DPP), however due to insufficient provider knowledge and the time lapse between GDM and development of type 2 DM, the risk is often forgotten or lost in the transition of healthcare from a women’s obstetric care to primary care. This QI project sought to address this issue with a multifaceted approach to the issue and incorporates community involvement, multispecialty collaboration, and health communication.A community needs assessment was conducted through focus group interviews of women with history of GDM. 8 demographically diverse women were interviewed. Key findings of the study were unawareness about DPP among women and interest and motivation to commit to these programs if provided the opportunity. A major aspect of the project is collaborations of Obstetrics, primary care, and population health departments at UCSD with CDC certified DPPs. Local and nationwide DPPs were contacted to gain information on program resources, referral requirements and cost. An external referral system to the various DPPs was proposed to representatives from Obstetrics and population health and is under consideration.Certified Diabetes Educators (CDE) at UCSD were educated in DPP. Educational handouts and PowerPoint slides were developed and provided to the health educators to pass on to their GDM patients. A webpage with DPP resources was developed and captured in a QR code that is printed on a magnet to be handed out during delivery. Behavioral changes require readiness in an individual, which sometimes takes time. The magnet will provide a steady, reiterating reminder for the women after delivery to enroll in a National Diabetes prevention program when they are ready. Evaluation of this QI project will be through data gathered from collaborating DPPs. Quality measures will include 1. Referral rates from UCSD, 2. Enrolment rates, 3. rates of completion of at least 9 months in the program and, 4. rate of accomplishment of weight loss goals. The evaluations will be performed at 6 and 12 months.