Running head: SHARED MEDICAL APPOINTMENTS FOR DIABETES (SMAD) 1
SHARED MEDICAL APPOINTMENTS FOR DIABETES, TYPE 2 (SMAD)
CURRICULUM SPRING 2014 COURSE SYLLABUS
COURSE COORDINATOR: REBECCA BATES, MSN, RN, FNP-C
SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 2 TABLE OF CONTENTS General Information..3 Course Description.3 Mission/Vision.3 Course Objectives...4 Course Outline..5 Course Format..6 Methods6 Expectations..6 Course Materials.6 Evaluation of Individuals..7 Evaluation of SMAD.7 References.8 Additional Resources..9 SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 3 SHARED MEDICAL APPOINTMENTS FOR DIABETES, TYPE 2 (SMAD) Course Coordinator Contact: Rebecca Bates, MSN, RN, FNP-C Phone: 703-777-1612 (at LSFP) Email: rbates@lmgdoctors.com
Loudoun Medical Group Contact: Mallory Rosetti, RN Phone: 571-209-1855 Email: mrosetti@lmgdoctors.com
COURSE DESCRIPTION This course is designed to provide individuals living with diabetes, type 2, who are adult patients in an LMG-affiliated practice, an opportunity to participate concurrently in group education and to have a medical appointment for follow-up of diabetes. Individuals will receive focused medical care and diabetes education to establish effective diabetes self-management skills. Group members will participate in education, demonstrations, return-demonstrations, and discussion over a four- session course. MISSION/VISION STATEMENT The mission of SMAD is to: Provide high quality, cost effective diabetes education to individuals who are patients of an LMG-affiliated practice; Offer health information and health services in an inter-collaborative format; Advocate for individuals living with diabetes; SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 4 Provide community education programs; Ensure compliance with NCQA Diabetes Recognition Program (DRP) and AADE-7 Self-Care Behaviors. The vision of SMAD is: Persons living with diabetes have the right to diabetes education; Access to high-quality, cost-effective healthcare will improve outcomes for patients. Diabetes education offered through LMG provides patients with continuity of care. LMG is a health care leader. COURSE OBJECTIVES Objectives are consistent with AADEs National standards for diabetes self- management education and support, NCQA Diabetes Recognition Program (DRP), CMS PQRS Reporting, and Healthy People 2020 objectives (AADE, 2013; CMS, 2013; NCQA, 2012; DHHS, 2010). 1. Improve glycemic control among persons with diabetes. 2. Improve lipid control among persons with diabetes. 3. Increase the proportion of persons with diabetes whose blood pressure is under control and are taking an ACE or ARB. 4. Increase the proportion of persons with diabetes who have at least an annual dental examination. 5. Increase the proportion of persons with diabetes who have at least an annual foot examination. SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 5 6. Increase the proportion of adults with diabetes who have an annual retinal eye examination. 7. Increase the proportion of adults with diabetes who have a glycosylated hemoglobin (A1C) measurement at least twice a year. 8. Increase the proportion of persons with diabetes who obtain an annual urinary microalbumin measurement. 9. Increase the proportion of adults with diabetes who perform self-blood glucose monitoring at least once daily. 10. Increase the proportion of persons with diabetes who receive formal diabetes education. 11. Decrease the proportion of persons with diabetes who use tobacco. 12. Increase the proportion of persons with diabetes, with no contraindications, who use daily aspirin therapy. COURSE OUTLINE Clinical Care: Each individual will receive a focused medical examination at each SMAD visit. This will include vital signs, medication reconciliation (patients will bring their medications to each visit), medication refill, and referrals as needed. Collaboration: SMAD will be provided by a provider (Nurse Practitioner, Physician Assistant, or Physician), nurse (RN), and/or diabetes educator. Education: Each session will have specific objectives, presentation/content, activities, and materials coordinated to enhance the individuals learning.
SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 6 COURSE FORMAT Welcome: (15 minutes) sign-in, nametag, vital signs, up-date medication list Warm-up: (15 minutes) sharing, review goals/attainment from previous session Education: (30-45 minutes) varies depending on session topic Wrap-up: (15 minutes) goal setting and closing discussion METHODS 1. Cognitive: Presentation/content will be problem-based and provided in a variety of formats to enhance the adult learners education. Patient education materials will be provided during each session to reinforce the objectives of that session. Content will support evidence-based knowledge, skills, and abilities and current practice guidelines. 2. Affective: Individuals will be encouraged to and assisted with setting goals including behavior change to improve diabetes self-management. 3. Psychomotor: Activities may include demonstrations, group participation, individual learning opportunities, and problem-solving. EXPECTATIONS Individuals will complete a confidentiality agreement prior to the start of the first session. Participation in SMAD is voluntary and individuals may decide to access individual appointments for diabetes care instead. Individuals are expected to participate in group discussion at their comfort level. COURSE MATERIALS Course materials will be related to the session objectives and may include smart phone applications, patient education handouts, web sites, or books. SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 7 EVALUATION OF INDIVIDUALS Measurable outcomes based on the objectives listed above and behavior change (healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, healthy coping) will be assessed for each individual prior to the first SMAD session and again after six months (completed two sessions) and twelve months (completed four sessions) of participation. EVALUATION OF SMAD Session evaluation will be provided to participants at the end of each session. Results will be evaluated for session improvement opportunities.
SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 8 REFERENCES American Association of Diabetes Educators (AADE). (2013). Crosswalk for AADEs diabetes education accreditation program. Retrieved from http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/accre d/Final_Crosswalk_-_3-2013.pdf American Diabetes Association (ADA). (2014). Type 2 lou. Retrieved from http://web.diabetes.org/link/link_for_life/main.html?loc=facts-about-type2 Center for Medicare and Medicaid Services (CMS). (2013). Diabetes mellitus (DM): Algorithm for measures calculation EHRS. Retrieved from http://www.cms.gov/Medicare/Demonstration- Projects/DemoProjectsEvalRpts/downloads/MMA649_DM_EHRS_Algorithm. pdf Healthy Interactions. (2014). The U.S. diabetes conversation map program. Retrieved from http://www.healthyinteractions.com/conversation-map- programs/conversation-map-experience/current-programs/usdiabetes National Committee for Quality Assurance (NCQA). (2012). Diabetes recognition program (DRP). Retrieved from http://www.ncqa.org/Portals/0/Programs/Recognition/RPtraining/2012_D RP_Workshop_revised_Aug_2012.pdf National Diabetes Education Program (NDEP). (2013). 4 steps to manage your diabetes for life. NIH publication No. 13-5492. U.S. Department of Health and Human Services (DHHS). (2010). Diabetes. Retrieved SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 9 from http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.as px?topicId=8
SHARED MEDICAL APPOINTMENTS FOR DIABETES
v.5/14 10 ADDITIONAL RESOURCES
American Diabetes Association 1-800-DIABETES (1-800-342-2383) www.diabetes.org
American Association of Diabetes Educators (AADE) 1-800-338-3633 www.diabeteseducator.org
Centers for Disease Control and Prevention 1-800-CDC-INFO (1-800-232-4636) www.cdc.gov/diabetes
National Committee for Quality Assurance (NCQA) Diabetes Recognition Program (DRP) 1-888-275-7578 www.ncqa.org/DRP
National Diabetes Education Program 1-888-693-NDEP (1-888-693-63370 www.YourDiabetesInfo.org
National Institute of Diabetes and Digestive and Kidney Dieseases 1-800-860-8747 www.diabetes.niddk.nih.gov
(Oxford Medical Publications) Graham, Philip Jeremy - Turk, Jeremy - Verhulst, Frank C-Child and Adolescent Psychiatry - A Developmental Approach-Oxford University Press (2007)