Starting a Diabetes Self-Management Program in a Free Clinic

Purpose The purpose of this project is to develop and implement a system of care for people with type 2 diabetes in a free clinic setting. Methods This project was conducted in the Homestead/Florida City community at the Open Door Health Center (a free clinic for the uninsured poor). Through a grant from the Robert Wood Johnson Foundation® Diabetes Initiative, organizational and programmatic changes were made to improve care for patients with type 2 diabetes. Program participation and clinical data, incorporation of healthy practices and programs in other community organizations, and the success of collaborations were evaluated to judge program success. Results Critical factors for providing health care for persons with type 2 diabetes in a free clinic setting were identified. These included reviewing and organizing medical records of patients with diabetes, developing a system that made efficient use of limited staff resources, finding an educational approach appropriate for the population served (ie, Popular Education), involving patients in self-management support roles by providing them the opportunity and training to become peer mentors, and developing strong community partnerships to complement and reinforce self-management. Conclusion Creation of a successful system of care for patients with diabetes in a free clinic setting is possible through innovative collaboration and creative program design.