A Transition of Care Model From Hospital to Community for Hispanic/Latino Adult Patients With Diabetes.

Summary

Participation Requirements

Description

This pilot study is designed to develop, test, and determine the feasibility of a transition of care model from hospital to the community for adult Hispanic/Latino patients with diabetes. The proposed study utilized the Plan-Do-Act-Study (PDSA)as a framework. The PDSA is an iterative process that al...

This pilot study is designed to develop, test, and determine the feasibility of a transition of care model from hospital to the community for adult Hispanic/Latino patients with diabetes. The proposed study utilized the Plan-Do-Act-Study (PDSA)as a framework. The PDSA is an iterative process that allows us to test on a small scale and document unexpected observations and determine what modifications should be made and prepare for next test. A culturally centered ToC model will be develop based on the following data: 1) results from semi-structure interviews from our first cohort of Hispanic/Latino participants with diabetes recently discharged from the hospital (n=4) and providers from the hospital and community (n=6); 2) feedback from participants in the community during the Community Consultation Studio think tank. Once developed, the ToC model will be tested with a total of 16 participants discharged from the hospital to the community. The model will incorporate the preference and perspective of providers and patients. Participants will complete a set of of questionnaires (demographic, sociocultural and medical history) prior to discharge and a follow up telephone call interview 30-days post discharge. A total of 5 participants for the first set of participants will be interview. These interviews will be analyzed for common patterns and themes for which the results will inform improvement of the ToC. A second cohort of participants (n=16) will be enrolled. And complete the same set of questionnaires along with the 30 day post discharge telephone call. Finally, after implementing and enrolling the second cohort, as small subset will be interview including providers (n=3) to obtain additional information that will inform further improvement of the ToC.

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