Date of Graduation

Summer 8-9-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Nancy Taquino, DNP RN CNL




Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to improve glycemic control (HbA1c< 8) among Hispanic/Latino diabetes patients by 1% from a baseline of 9.8% to 8.8% per KP Riverside HEDIS data using best practices created from evaluating the relationship between organizational leadership and community effects on clinical outcomes by performing a PDSA cycle by Q4 2018. The initiative is a 2-year commitment, budget approval will be required for both 2017 and 2018. A 1% decrease in HbA1C is significant in preventing microvascular and macrovascular complications in poorly controlled diabetes patients.

Results and Sustainability Plan

The results are the development of the project charter and the implementation plan for beginning work with this site. Long and short term sustainability plans are needed to support the success of this project and to integrate the global goal of health equity. The short-term plan includes the CNL assuming the role of the performance improvement advisor and collaborating with the inter-professional team to implement the improvement process (AACN, 2013; Harris, Roussel, & Thomas, 2017). This includes conducting a quick baseline survey or microsystem assessment to understand current practices and identify gaps. Long term plan includes on-going assessment of the microsystem and performance improvement data to demonstrate sustainability and identify new improvement opportunities.

Keywords: diabetes, health equity, Hispanics, Latinos, costs, diabetes management, health disparities, and best practice strategies.