Dr. Martin Luther King, Jr. Health Center

Project Title

Dr. Martin Luther King, Jr. Health Center Diabetes Management Initiative

Award Amount

$214,210

Location

The Bronx

Date Awarded

November 15, 2007

Diabetes has reached epidemic proportions among communities served by the Dr. Martin Luther King Jr. Health Center, with 11% to 17% of adults reporting having diabetes—well above New York City’s average (9%). This project seeks to expand the Center’s existing diabetes management program to all 14 sites which includes the implementation of a diabetes patient registry and training of staff in the chronic care model and diabetes self management.

The Dr. Martin Luther King, Jr. Health Center will expand its existing diabetes management program in internal medicine from two of its sites to 12 additional sites, and make the program the standard of care across all 14 practices in its network. The health center will conduct trainings on the Chronic Care Model, Community Health Worker Model, and guidelines for diabetes care. By involving residents in this training, the health center will foster long-term adoption of these practices. A key component of the initiative will be a diabetes patient registry, which will be accessible to providers at all sites and used to track program and patient-specific outcomes. Diabetes teams at each of the clinics—comprising physicians, nurses, residents and administrative personnel—will champion the effort and oversee its implementation. In one Family Medicine Clinic, an existing diabetes management program will be paired with a community health worker program to test how the two programs can work together to affect patient outcomes. Community health workers will provide peer support for diabetic patients, educating them in self-management and helping them to take an active role in their health.