MULTI PURPOSE DIABETES WORKERS: THE BHARTI HOSPITAL FOURTIER MODEL

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MULTI PURPOSE DIABETES WORKERS THE BHARTI
HOSPITAL FOUR-TIER MODEL

• Dr. Sanjay Kalra
• D.M. (AIIMS)
• BHARTI HOSPITAL KARNAL.

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INTRODUCTION

• This presentation reports on a four tier model
  developed by a pioneer institution located in an
  underserved area of northern India .

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BACKGROUND

• Delivery of diabetes care is a challenging task.
• No single individual can provide all the services
  that a person with diabetes requires.
• Trained staff is not available in many
  underserved areas.
• The staff that is available is often overwhelmed
  by the number of patients.

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SOLUTION

• The Bharti Hospital Karnal has developed a 4 tier
  model which utilize Multi purpose Diabetes Worker
  (MPDWs) to provide diabetes care in a 4-tier
  model.

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FIRST - TIER

• It consists of MULTI PURPOSE DIABETES WORKERS.
• Multi Purpose Diabetes workers are trained by the
  Hospital itself.

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FIRST -TIER

• Multi purpose diabetes workers handle-
• Basic diet.
• Exercise.
• Podiatry Management.
• Self Initiation and handling of insulin doses.

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FIRST -TIER

• They are capable of recognizing ketosis and foot
  complications.
• They are effective in achieving Behaviour
  Modification.
• They are able to carry out triage of patients.

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SECOND -TIER

• It consist of -
• Dietician
• Physiotherapist
• Clinical Psychologist.
• Each specialist handles his or her aspect of
  diabetes care in patients.

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THIRD -TIER

• It consists of Endocrinologist.
• Endocrinologist handles
• medical and endocrine aspects of diabetes.
• supervises and trains the first two tiers
  professional.
• captains the team.

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FOURTH -TIER

• It consist of
• Reproductive Endocrinologist.
• Pregnancy Specialist.
• Foot Surgeon.
• Retina Specialist.

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CONCLUSION

• Characteristics of Four-Tier Model
• Self designed.
• Self sustaining.
• Commercially viable.
• Time efficient.
• Works well in trained diabetes underserved areas.