Quality improvement (QI) methodology and tools were used when a service needed to quickly adapt during the COVID-19 pandemic.
As the Diabetes Service at Kent Community Health NHS Foundation Trust (KCHFT) switched from offering an education programme face-to-face to doing it virtually, plan study do act (PDSA) was used, in an informal way, with the package continually tweaked as issues arose. There was also a patient focus group, with those who use the service involved from the outset, feeding back with what would work for them.
Before the COVID-19 pandemic, patients referred to KCHFT’s Diabetes Service, for type 2 diabetes education, were offered a four-hour face-to-face workshop, where they would learn more, have the chance to speak to dietitians and diabetes nurses and meet others, who had been recently diagnosed. The sessions were held across the county in village halls, leisure centres, GP surgeries and other venues.
The pandemic meant these had to stop at the end of March last year. So, to make sure that patients were still being cared for, the education package was quickly re-visited and now, patients are offered a two-hour virtual meeting, to find out more and to meet up.
Margaret Levison, Operational Lead with KCHFT’s Diabetes Service, (pictured) said: “We’ve been holding the new two-hour virtual sessions several times a week, since we launched them in July.
“We’ve had good feedback, with our patients really grateful that we are able to do this for them. “
Susan Parsons, Clinical Lead with KCHFT’s Diabetes Service, adapted the education package so it could be delivered virtually. It works via a system called Attend Anywhere.
Susan and Margaret ran a pilot and gathered patient feedback via a focus group. The package was tweaked as a result of comments and then rolled out across Kent.
Margaret said: “With it being virtual, we can deliver to groups of patients who might live anywhere in the county, now they don’t all have to live within a few miles of the venue.
“We started with six people, including the staff member running the session, but found this was too many, so now invite just four patients at a time. We also found it didn’t work well on phones, a laptop or a tablet is needed.
“For patients who don’t have the equipment, or do not get on with the technology, we offer a phone service instead.”
The session explains what diabetes is, includes dietary advice and signposts people to Diabetes UK. Patients are sent information afterwards in case they missed anything and are able to download a booklet, which can be used at appointments.
As the service looks to continually improve and to work better, a new system was introduced in January 2021, where all GP referrals are now sent to a central system for Kent and Medway. This system allocates appointments – and saves the service time on admin.
The education programme is known as DERIK – Diabetes Education and Revision In Kent and is accredited by the Quality Institute for Self Management Education and Training (QISMET). With accreditation reviewed every three years, the service is about to submit its virtual package.
Margaret has completed a five-day quality, service improvement and redesign (QSIR) practitioner course with KCHFT, so was aware of how QI tools could help. Margaret and Susan continually tweaked how the programme was delivered, changing one thing at a time to see if it made a difference. They also knew the importance of involving patients in any changes which were made.
Margaret said: “It’s exciting to be doing something different and moving forward, we will definitely keep this virtual package, as a lot of patients prefer it.”
Feedback from patients who have attended the virtual sessions has included the following: “I attended the DERIK course with a reading of 61. Since then, I have lost five stone and now my number is 39! So in remission! Thanks to your course I totally understood what I needed to do and more importantly keep doing.”
Another patient commented: “Having completed the DERIK session today I thought it right that I should thank you for the arrangement and to thank you very much for providing the program.
“All I, along with the others attending, have to do is to take on board what we have learnt. It will be interesting to learn my next session of blood readings.”