Tools to Identify Appropriate Problems to Solve – Type 2 Diabetes
The following tools can help stakeholders focus on the most pertinent problem(s) to solve.
Root Causes of Practice Challenges
The Fishbone diagram can help identify root causes of practice challenges
- A structured team process is used to identify causes of a health care problem
- Brainstorm sessions highlight possible causes of a problem and sort them into categories
- Output informs the development of an action plan to improve on challenges, care, and/or outcomes
Select resources include:
Defining potential challenges for type 2 diabetes prevention, patient self-management, and treatment
The following represents common challenges that can contribute to poor type 2 diabetes outcomes and management in communities of color. Stakeholders can take these factors into consideration when exploring and identifying potential problems to solve in their health system.
- Lack of knowledge about type 2 diabetes standards of care and disease disparities among the practice team
- Lack of process or method for tracking type 2 diabetes outcomes by race and ethnicity
- Clinical inertia when insulin is required
- Access to affordable high-quality medications
- Lack of knowledge about common comorbid conditions developed by patients of color, such as kidney disease and heart failure, and how some diabetic medications can prevent or delay these conditions
- Practice-based challenges in consistency of patient visits (eg, removing shoes to examine feet of every patient)
- Assuring that telemedicine use truly engages patients of color
- Cultural sensitivities in communities of color (eg, mistrust of the medical system, fear of “naming it and claiming it,” fear of abandoning cultural foods)
- Lack of patient education on benefits of lifestyle changes that are in alignment with cultural practices but are tweaked to better manage disease
- Identification of community resources for patient education and self-management, healthy food, and exercise
Issue and Cause Worksheet
The following table can be used to help stakeholders outline the specific problems to solve, as well as the respective causes surrounding them, which will eventually help inform solutions.
The workflow analysis, or process mapping, can be a useful exercise to help the team find bottlenecks and opportunities to improve practice