Senge points to five attributes of these learning organizations in his widely cited book, The Fifth Discipline: a Shared Vision (1), Mental Models (2), Team Learning (3), Personal Mastery (4) and System Thinking (5).
Shared Vision: Reducing the Number of People with Diabetes in Montgomery County
Minimize the number of Montgomery County residents who have diabetes. Increase the resources available in the community including boosting education about diabetes prevention and self-management for those who suffer from diabetes.
This is what Nexus Montgomery aims to achieve with the creation of the Diabetes Educators’ Learning Collaborative [Learning Collaborative]. It’s part of a five-year program – funded by a Health Services Cost Review Commission Catalyst Grant– that aims to significantly improve diabetes education and prevent new cases of diabetes in Montgomery County.
The Primary Care Coalition serves as the management entity for Nexus Montgomery, a collaborative of the six hospitals in Montgomery County. Isabel Rodriguez, the Diabetes Program Manager at the PCC, shared the priorities for the first year of this new program, “It’s a planning year, building the capacity and to then start increasing the services.” Increased support for educators should translate into less residents who develop diabetes and enhanced care for those who already have diabetes.
Set to launch in early May 2021, the Learning Collaborative offers a home for diabetes education providers and lifestyle coaches to share challenges, resources, and best practices for how to improve the programs they run. Those programs: the Diabetes Prevention Program [DPP] aimed at high-risk individuals who don’t yet have the disease and Diabetes Self-Management Education [DSME] designed for individuals who already have diabetes.
In Montgomery County where the Primary Care Coalition works to increase access to affordable health care and related services, several key hospital and community partners offer diabetes education; including a mix of both DPP and DSME.
Personal Mastery: Training is an On-Going Process
The DPP is a CDC-recognized curriculum that lasts for one year – potentially two years for Medicare beneficiaries – and serves the population that’s at high-risk for developing diabetes. The goal is for participants to lose five percent of their weight; a target based on ample scientific research.
To hit those numbers, lifestyle coaches teach their patients how to:
Change the way they eat
Cope with difficult situations or triggers
Get started with or increase physical activity within their abilities
Use stress management throughout their journey.
During the first six months of the program, patients meet with their coaches 16 times. It’s a massive time commitment.
The DSME includes up to 10-hours of education throughout the year. Some can be 1-on-1, and the rest is offered in group settings. Since participants in this program already have diabetes, the goals of the program are to improve self-management of the condition, and reduce the risk of complications. The education revolves around managing the disease, including medication education and training, monitoring and understanding test results, and like the DPP developing or improving skills to support healthy eating and increased physical activity.
Continual education for diabetes education providers and lifestyle coaches strengthens the county’s ability to prevent the onset of the disease and improves patient outcomes. Another step toward the shared vision.
Mental Models: Open to Others Experience & Expertise
Rodriguez highlighted the benefit of our virtual world to reach populations that providers might not have reached before. That also means “exposure to different perspectives that other lifestyle coaches have come across. For example, they can ask others ‘how did you engage with that group on the healthy eating education or how did you re-engage someone who didn’t want to come back?’” said Rodriguez.
The most effective organizations and teams understand what they know, but more importantly, can also identify knowledge gaps. The Learning Collaborative offers an open and inclusive environment that fosters learning. It will be particularly useful for the DPP’s lifestyle coaches who must go through some training, but don't need a formal education in healthcare to successfully do their job.
Team Learning: Stronger Together
Grace Townsend, the Diabetes Program Coordinator, spoke about virtual sessions expanding the learning potential of the Learning Collaborative. "Virtual sessions have allowed various groups of people from different parts of the area to come together, and they will also allow us to really identify best practices.”
It’s about meeting people where they are to offer support, Townsend added. Community center partners act as a focal point for residents. Due to their centrality, it’s a great opportunity to contact people who are high-risk for diabetes and educate them about available resources.
The knowledge that the Learning Collaborative has regarding diabetes care is ineffective if residents can’t access it. Community centers are limited in terms of the life services they can provide. Combined, they create a healthy partnership for all which only happens when the partners are open to collaboration.
Systems Thinking: The Intersectionality of Health Care
The Learning Collaborative emphasizes the importance of sharing knowledge amongst the lifestyle coaches and diabetes education providers. “Everyone has a different background, teaching style, learning style, and varying levels of creativity that can help the collective improve the sessions they provide to Montgomery County’s diverse groups,” Rodriguez said.
The Learning Collaborative aims to create a supportive place for educators to get to know each other and learn from each other. Rodriguez outlined what they want to see come out of this planning year: “We’d love to see that they come to PCC with their issues so that we can bring it to the whole group and plan for more robust conversations and identify resources to bring to [future] sessions."
Organizations that understand their place in the entire sector, as well as across multiple sectors, are more responsive to the needs of their community and more likely to adapt successfully to a changing environment. --- If your organization would like to join the Diabetes Educators’ Learning Collaborative – and offer either the Diabetes Prevention Program or Diabetes Self-Management Education – please contact Grace Townsend at: email@example.com. --- *The article has not been reviewed or approved by Montgomery County Department of Health and Human Services (DHHS)*