Featured Articles: Quality Improvement

Helping Patients Successfully Manage Type 2 Diabetes: Rinehart's Diabetes Risk Reduction Program

Tuesday, March 13, 2018   (0 Comments)
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Blast from the Past: This article was originally featured in the March 2018 Northwest Pulse issue


Denise Weiss, RN, Quality Director and Leigh Ann Hoffhines, Communications Manager, Rinehart Clinic


Rinehart Clinic’s healthcare team has long recognized the challenges patients with diabetes face and the impact the disease has on the health of the broader community. Roughly nine percent of Tillamook County residents have been diagnosed with type 2 diabetes, and nearly 33 percent of adults are at risk for the disease.  

Because we serve a population susceptible to diabetes and other chronic health conditions, preemption and management have become a focus in our approach to healthcare. During 2017, the care team at Rinehart Clinic launched a comprehensive Diabetes Risk Reduction Program made possible by grant funding from the Columbia Pacific Coordinated Care Organization. The program helps patients make positive strides towards overcoming some of the risk factors of diabetes, including obesity and sedentary lifestyles, through a broad approach to care. 

The program has been in place since mid-2017 and the clinic is seeing positive outcomes for participating patients:  lowered blood sugar numbers (A1C), lower blood pressure, healthier eating habits, and even weight loss. 

The clinic’s care team recognizes that some patients may face barriers – economic, emotional, and motivational challenges that make it difficult for them to seek treatment. From a patient’s perspective, the first step towards getting help may be the hardest:  walking through the doors of a healthcare facility. The care team at Rinehart Clinic has found the single most important factor in bringing about positive change is creating a supportive environment for treatment and for group classes. 

To help make it easier for patients to participate, the clinic offers incentives for those who join in the programs. This past year, the clinic’s weight loss/walking group members received pedometers, healthy eating class participants went home with fresh vegetables each week, and many class members received vouchers for free fitness and aquatics classes at North County Recreation District. 

The clinic holds a variety of healthy lifestyle classes throughout the seasons, shying away from traditional lecture-style trainings, and opting instead for informal and interactive conversations that are often driven by the participants themselves. 

Rinehart Clinic’s class lineup includes:


  • A Weighty Discussion series, which offers an informal conversation around healthy eating and weight loss. Some of the participants also joined in a weekly walking group during the summer months.
  • A popular Art of Eating class, where patients learn how to increase the use of vegetables in their diets in healthy and creative ways.
  • Living Well with Diabetes, which offers supportive tools to help patients manage diabetes and pre-diabetes conditions. 
Living Well Class with Terra Marzano and Denise Weiss
Walking group participants


Several community partners who believe in the importance of a healthy community have rallied behind Rinehart Clinic’s Diabetes Risk Reduction Program: 


  • North County Recreation District, which provides fitness and aquatics passes for patients to help them become more physically active.
  • Moon River Farms, a local organic farm that provides shares of vegetables through its Community Supported Agriculture (CSA) program for the Art of Eating classes. 
  • Manzanita Farmers Market offers participating patients vouchers for free fruits and vegetables at the market throughout the summer and fall program.
  • Manzanita Grocery and Deli, long known for its commitment to the well-being of the community, is also offering a voucher program to provide fresh produce in winter when the local farms are not producing. 

While the grant funding helps supplement our partners’ contributions, their support and participation is critical to the program’s success. 

For other primary care clinics planning to launch a program like Rinehart Clinic’s focus on reducing and managing diabetes, there are several key elements that will help set the stage for success:  

  • Teamwork – A strong team approach is crucial. We are fortunate to have a compassionate care team behind the program so there is consistency and support for our patients every step of the way. 
  • Prioritization and Planning – There needs to be an emphasis placed on addressing the effects of diabetes (or whatever chronic condition your clinic hopes to address), and a broad plan on how to go about it. Involve the team so everyone is on board and understands the big picture, as well as the importance of each component of the plan.
  • Support – You will need support from leadership, financial and structural support. In Rinehart Clinic’s case, we built in incentives for patients and adjusted staff schedules to accommodate additional patient education opportunities both in a group setting and one-on-one with one of our Registered Nurses when necessary.
  • Collaborative Community Partners – It’s helpful to have community partners who share your mission of fostering a healthy community and are committed to collaborating on your project. 

If you would like more information on Rinehart Clinic’s Diabetic Risk Reduction program, contact Quality Director Denise Weiss at dweiss@rinehartclinic.org.




NWRPCA welcomes and regularly publishes white papers and articles submitted by members, partners and associates with subject matter expertise. The appearance of any guest publication in our Health Center News database represents the views of the author and does not constitute endorsement by NWRPCA of the stated opinions or perspectives, nor does it suggest endorsement of the contributor's products or services.

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