Story by Douglas Stutz on 04/19/2017Naval Hospital Bremerton's (NHB) Intensive Diabetes Care Clinic (IDCC) has completely revamped how the command is helping patients deal with the disease.
All in one comprehensive visit.
"We refer to it as one stop shopping.' Any patient who is referred to our clinic by their provider will have everything they need. Our idea is to help facilitate those at risk from the complications of diabetes," said Kristen B. Thorstenson, Population Health registered nurse.
The idea to combine all resources available at NHB into a flowing, complete arrangement where a patient visits one specialist after another originated with Lt. Cmdr. Lynn Byars, Internal Medicine and Urgent Care Clinic physician.
"We do have a lot of assets here for our patients. It could be difficult for them at times to navigate from one clinic to another, perhaps on different days or different times. We've brought it all together for those who need it the most," Byars said.
A patient is initially seen by a hospital corpsman for the preliminary check-in process, before the appointment with the provider, followed by meeting with a registered dietitian, pharmacist, and a behavioral health expert.
"There have been positive, receptive comments from our patients. There was some skepticism at first because of the long appointment that can last almost two hours at times. But then they see all that they are getting done and find the services being offered here are very supportive for their needs," Byars said, also stressing that the IDCC is not a substitute for any patient's primary care manager (PCM) but is there to assist and augment the patient-centered care they already receive.
"We're not a PCM replacement but an adjunct with all of our services," added Byars.
The holistic, all-inclusive clinic covers such topics as glucometer use, healthy eating, and proper understanding and usage of diabetes medication.
The registered dietitian provides support on establishing nutritional, balanced meal programs by relying on accumulated knowledge from the patient, then coordinating with them to put together a feasible game plan.
"We don't scold. We educate," noted Thorstenson.
The registered nurse or health educator can also help organize a patient's fitness plan by initiating a physical assessment registration and getting them to see a personal trainer at Naval Base Kitsap fitness facilities.
The behavioral health consultation portion of the visit offers assistance to reduce symptoms associated with diabetes by developing behavioral change plans for weight loss, exercise and/or other lifestyle modifications.
"We take the necessary time to listen. Part of what I do is just talking to people, but mostly I listen. When we get a patient to open up and explain what they are feeling and what they are dealing with, that is very important because with a clear picture we really help them and their doctor," said Lori Martinelli, Behavioral Health Registered Nurse.
Approximately 170 patients have been seen in the weekly IDCC since starting in October 2016.
"I'm so excited for this. We're seeing progress. Every patient seen today has shown an improvement in some aspect of their management of dealing with diabetes which is resulting in better health for them. It's a process and they are doing it," stated Byars.
The IDCC program is part of the joint Puget Sound Military Health System partnership between NHB and Madigan Army Medical Center, with Lt. Col. B. Glister, endocrinology doctor participating.
After the initial IDCC visit, a patient has follow-up appointments every three months, six months and one year. There is also a Diabetes Care line available - 360-475-5492 if needed.