Name
Poster 26 - Improving Diabetes Care Through a Primary Care Behavioral Health Pathway: A Quality Improvement Project
Date & Time
Friday, October 17, 2025, 5:00 PM - 6:30 PM
Location Name
Lobby - ABC Ballroom
Description

The American Diabetes Association Standards of Care in Diabetes 2025 highlight the impact of psychological wellbeing and health behaviors (i.e., diet, exercise, medication adherence) on patient outcomes, and thus, recommend health behavior change strategies and psychological interventions be routine practice for clinicians caring for patients with diabetes (ElSayad et a., 2025). These updates highlight the integral role of team-based care practices in meeting the diabetes guidelines without further burdening clinicians’ schedules and limiting clinician accessibility. The present quality improvement project collected primary care staff and clinician perceptions of a team-based approach to diabetes care management before and after the implementation of a care pathway for adult patients with Type 1 or Type 2 diabetes in a Family Medicine Residency continuity clinic. The Plan-Do-Study-Act (PDSA) approach was used to build and evaluate the pathway, which was designed based on the recommendations from the 2025 diabetes guidelines (Taylor et al., 2014). The pathway prompted clinicians and staff to consult the Primary Care Behavioral Health (PCBH) Consultation service based on patients’ lab results (A1C > 9.0), changes to psychological wellbeing including onset of psychosocial stressors, and changes to treatment or medication adherence (i.e., reported/evident nonadherence). 28 team members from the clinic completed a pre-survey and 19 team members from the clinic completed a post-survey using 7-item Likert scales examining perceptions of team communication, collaboration, and satisfaction in supporting diabetes care. The survey also examined perceptions of the team’s competency addressing both medical and behavioral/psychological aspects of diabetes management. Descriptive statistics were used to analyze changes in perceptions from pre- to post-survey implementation. The mean of the pre-implementation survey was a 4.63 (SD = 1.46), and the post-implementation survey mean was a 5.1 (SD = 1.19). The sample mean was 4.82 (SD = 1.38). Results indicated an improvement in perceptions of communication, collaboration, and satisfaction with the team’s performance managing diabetes care. Future quality improvement approaches may measure the impact of the clinical pathway on patient outcomes (e.g., lab values, medication adherence, diabetes distress) to further examine the efficacy of the pathway. This pathway provides a “checklist” and structure for primary care teams, which may be replicated in other medical settings to improve the consistency with clinic engagement with the diabetes guidelines, also improving the likelihood of achieving health equity for marginalized patients, standardizing access to evidence-based treatment for all patients.

Rae Narun Stacy Ogbeide Yajaira Johnson-Esparza
Tags
Primary Care Behavioral Health Model, Quality improvement programs, Team-based care
Session Type
Poster
SIG or Committee
Medicine, Primary Care Behavioral Health (PCBH)
Objective 1
Understand the components of a clinical pathway for diabetes
Objective 2
Identify the steps in a Plan-Do-Study-Act approach
Objective 3
Employ best practices for quality improvement in a primary care clinic
Content Reference 1

ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., Ekhlaspour, L., Garg, R., Khunti, K., Lal, R., Lingvay, I., Matfin, G., Pandya, N., Pekas, E. J., Pilla, S. J., Polsky, S., … Bannuru, R. R. (2025). 1. improving care and promoting health in populations: Standards of care in diabetes—2025. Diabetes Care, 48(Supplement_1). https://doi.org/10.2337/dc25-s001

Content Reference 2

ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Eichorst, B., Ekhlaspour, L., Garg, R., Hassanein, M., Khunti, K., Lal, R., Lingvay, I., Matfin, G., Middelbeek, R. J. W., Pandya, N., Pekas, E. J., … Bannuru, R. R. (2025). 5. facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes—2025. Diabetes Care, 48(Supplement_1). https://doi.org/10.2337/dc25-s005

Content Reference 3

Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ quality & safety, 23(4), 290–298. https://doi.org/10.1136/bmjqs-2013-001862