The Rapid Implementation of an Innovative Virtual Diabetes Boot Camp Program: Case Study

Background COVID-19 disrupted health care, causing a decline in the health of patients with chronic diseases and a need to reimagine diabetes care. With the advances in telehealth programs, there is a need to effectively implement programs that meet the needs of patients quickly. Objective The aim of this paper was to create a virtual boot camp program for patients with diabetes, in 3 months, from project conception to the enrollment of our first patients. Our goal is to provide practical strategies for rapidly launching an effective virtual program to improve diabetes care. Methods A multidisciplinary team of physicians, dieticians, and educators, with support from the telehealth team, created a virtual program for patients with diabetes. The program combined online diabetes data tracking with weekly telehealth visits over a 12-week period. Results Over 100 patients have been enrolled in the virtual diabetes boot camp. Preliminary data show an improvement of diabetes in 75% (n=75) of the patients who completed the program. Four principles were identified and developed to reflect the quick design and launch. Conclusions The rapid launch of a virtual diabetes program is feasible. A coordinated, team-based, systematic approach will facilitate implementation and sustained adoption across a large multispecialty ambulatory health care organization.

Toward Preventing Speech and Language Disorders of Known Genetic Origin: First Post-Intervention Results of Babble Boot Camp in Children With Classic Galactosemia

Purpose Babble Boot Camp (BBC) is a package of proactive activities and routines designed to prevent speech and language disorders in infants at predictable risk. It is implemented via parent training and currently undergoing clinical trial in children with a newborn diagnosis of classic galactosemia (CG), a metabolic disease with high risk of speech and language disorders. The purpose of this study is to provide updates to a previous pilot study and to present the first set of post-intervention results. Method The intervention and data collection occurred during child ages < 6–24 months, with follow-up assessments of speech and language at ages 2.5 and 3.5 years. Treatment targets included earliest vocalization rates, babble complexity, speech production accuracy, and vocabulary and syntactic growth. The oldest 15 children with CG (including three untreated controls) completed the first set of follow-up assessments. Aggregate data up to 10 months were available for 17 treated children with CG, six untreated children with CG, and six typical controls. Results At ages 7–9 months, babbling complexity, as measured with mean babbling level, was higher in the treated children with CG than in the untreated children with CG and the typical controls. Prior to 24 months of age, the treated children with CG had greater expressive but not receptive vocabulary sizes than an untreated control. Follow-up testing showed typical language scores for all 12 treated children with CG and typical articulation scores for 11 of these, whereas one of three untreated children with CG had low articulation and expressive language scores. Conclusions The BBC appears to be a viable intervention to support the speech and expressive language development of children with GC. Future studies will evaluate the relative contributions of the earliest and later BBC components to outcomes.

EP.TU.53Mark of Cain: lessons from a field hospital Boot Camp under COVID’s Cloak

COVID-19 restrictions have cursed and canceled most academic training events. Because of fears related to social distancing, centres normally housing &gt;100 delegates now accommodate only 12. Aim To assess the feasibility of a multidisciplinary Core Surgical Trainee (CST) Boot camp training event at a UK field hospital. Method All CST1s within a single UK Statutory Education Body were invited to participate in a three-day Boot camp at the Dragon’s Heart Hospital, Millennium Stadium, Cardiff, consisting of simulated, Operative and Non-Operative Technical Skills for Surgeons (NOTSS). Primary outcome measures were; satisfaction and perceived competence using Likert scale (1-5). Results Attendees numbered 44 (median age 29 yr. 21 female, 23 male). Median satisfaction scores by domain were: Overall course satisfaction 4 (range 2-5), simulation skills 5 (3-5), lecture-based learning 4 (2-5), academic skills 4 (2-5), and NOTSS 5 (1-5). Levels of perceived confidence in performing simulated index procedures improved markedly (before median 2 (1-5) vs. after 4 (2-5), (p &lt; 0.001). Free text comments reflected and praised the quality of staff commitment, enthusiasm, and in particular interactive workshops related to NOTSS. In contrast, resource limitations inherent to the marquee character of the venue (ambient temperature, IT limitations) received criticism. Conclusion COVID’s curse can be broken by creativity, enthusiasm, and engagement of translational multidisciplinary team leadership.

Assessing effectiveness of a self-guided training program for oncology financial advocates.

271 Background: Financial toxicity can be a devastating side effect for patients with cancer and their families, and may impact access to and delivery of care, treatment compliance, and outcomes. Financial advocates mitigate financial toxicity for patients and their families, liaise between payers/providers/pharmacies/patients, support shared decision-making and care planning processes through provision of cost and coverage information, and mitigate institutional financial toxicity. Training on effective financial navigation interventions, financial health literacy, patient engagement, oncology fundamentals, and measurement of impact is critical for advocates. Methods: The Association of Community Cancer Centers (ACCC) Financial Advocacy Boot Camp is a self-paced eLearning program consisting of 9 modules designed to build knowledge and skills of financial advocates. Users interact with education across two levels within the ACCC Learning Management System. To evaluate effectiveness of this content, pre- and post-assessments and evaluation forms for registered learners from 1/1/2020 to 12/31/20 were exported and exploratory analysis was performed on this data set of 538 participants. Results: 51% of respondents are oncology financial advocates; 7% are industry representatives; and the remaining 42% are a mix of patient navigators, nurse navigators, social workers, pharmacists, APPs, and nurses. 363 participants fully completed at least one of two levels. Most participants agreed or strongly agreed that each of the modules improved their knowledge and skills: 94% increased their ability to incorporate effective screening methods to identify patients at risk of financial toxicity, 95% are better able to review the evolving landscape of health insurance provided by public and private payers, and 97% both increased their ability to find patient assistance programs and resources for patients and can describe how to guide patients through the process of improving insurance coverage. 79% identified specific examples of what they will do differently after the training, including implementing screening and follow-up protocols, adjusting communication approaches with patients, proposing quality improvement projects, and accessing resources. Conclusions: Training, such as the Financial Advocacy Boot Camp, that builds knowledge and skills in financial screening, communication, and navigation can help cancer programs improve staffs’ ability to mitigate patient and institutional financial toxicity. Future research efforts should further define financial advocacy competencies, measure patient and institutional impact of financial navigation interventions, and assess effective practices for implementation of financial advocacy training in cancer programs.

SP2.2.17The leaning tower of pasta: lessons in team performance and creativity from a core surgical training boot camp design challenge

Aims Unity of effort is an important component of strategic leadership and management theory associated with Core Surgical Training (CST) outcome. The aim was to determine the impact of team diversity on task completion: a creative design challenge, during CST Boot camp. Methods Attendees (n = 44) at a single Statutory Education Body’s CST Boot camp were stratified into teams related to specialty theme, and set a design challenge as described by Peter Skillman, to build the tallest free-standing tower out of spaghetti (20 pieces), tape (1 m), and string (1 m), with a marshmallow on top in 18 minutes. Primary outcome measure was tower height. Results Five teams (50%) completed the task with the tallest tower measuring 70cm (median 51, range 0-70). Median satisfaction with the simulation exercise was 4 (2-5) on a scale of zero to five, with five corresponding with highest satisfaction. Successful task completion was associated with team surgical specialty (p = 0.032), ethnicity ratio (p = 0.010,), and gender ratio (p = 0.003), respectively. On multivariable analysis, only team gender ratio was independently associated with tower height (HR 0.515, 95% CI 0.350 - 0.759, p = 0.001). Conclusion Modern leadership theory emphasises the important dynamic relationship between individual team members, the team, and task completion. General surgery themed teams with a gender mix were most successful in completing the design challenge; whether relative simulation performance predicts strategic organisational skill and career progression will be the next question.