Team Insights: Grady Health Systems vs. Diabetes


By Mark Nissley

I was recently asked if I could capture the essence of Grady and their fight against diabetes in a paragraph or two. To do so in a 2-day session would be easy; in a couple paragraphs, it’s not as simple. You see, the Passion and Purpose that is the essence of the Grady fight against diabetic retinopathy is best captured by its people, and it is a fight. 

Grady has performed almost 15,000 diabetic retinopathy exams on a population that has revealed an astonishing 42% pathology rate. More than 2,400 of those total exams yielded critical results. Success in an environment like that requires commitment. That commitment at Grady is driven by its culture and the Grady people make that culture a tangible thing. A few stories come to mind.

Unlike many IRIS programs, the IRIS program at Grady was born in Ophthalmology. The Grady Eye Clinic was over capacity and the team there was deeply concerned that because they were maxed out, they were unable to perform a diagnostic exam on every patient with diabetes.

The Chief of Ophthalmology knew that innovative solutions would be required to serve that population. His passion to serve every one of his patients led Grady to partner with IRIS to ensure that every patient with Diabetes that presented themselves at Grady would get a Diabetic Retinal Exam.

It was “the right thing to do” and their resolve was powered by their passion and purpose. 

During the implementation at the first round of clinics, there was a resident that questioned how this exam was going to fit into the workflow. As we all know, the medical profession is one of the busiest, with a marked emphasis on efficiency. Residents have even more work on their plates.

In this case, the practice manager gently informed this resident that “giving our patients with diabetes the best care possible is just the Grady Way”. She also indicated that if the resident did not agree with this philosophy, Grady may not be the right place for him to complete his residency. Passion and Purpose.

Many healthcare systems implement the IRIS program to check a box and say that they are doing the right thing. At Grady, they take it to the next level, or the next 3 levels. One of the practice teams recognized that some patients with critical results were not showing up for their referrals at the Grady Eye clinic. This team worked with Grady’s top-notch EPIC Team to develop alerts that would tell them when these patients returned to any place in the Grady system. Those patients would then be escorted to the Grady Eye Clinic to get the care they need; again, guided by their passion and purpose.

My last story (for today) is an emotional one.  During recent rounds at the Grady primary care clinics, a Clinical Supervisor revealed that the implementation of the IRIS program at her Grady clinic compelled her to get her eyes checked at her ophthalmologist. She has had diabetes for years, but avoided getting an eye exam, just like many of her patients. She went to get a diabetic retinal exam. 

When the results came back, they revealed pathology. Her eye care professional told her that she had 3 months to get her diabetes under control or she’d have to start getting injections in her eyes. This startling diagnosis motivated this clinical supervisor to get her diabetes in check. Three months later her pathology had been reversed. As you may imagine, she is now an active and relentless advocate for her patients – passion and purpose! 

In this season of thanks, I am thankful for the opportunity to work with such amazing healthcare providers as the teams at Grady and the passionate, purposeful organizations they represent.

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