Diabetes Self-Management Education and Support (DSMES) Accreditation/Recognition 101

Transcription

1 Diabetes Self-Management Education and Support (DSMES) Accreditation/Recognition 101

2 What is DSMES? Diabetes Self-Management Education and Support (DSMES) Evidence-based intervention that strengthens the knowledge and skills of people with diabetes to optimize their ability to self-manage the disease.

3 Participant Eligibility Clients with a diagnosis of Type 1 Type 2 Gestational

4 Benefits of DSMES People who have received diabetes education are more likely to: Use primary care and preventive services Take medications as prescribed Control their blood glucose better Control BP and Cholesterol better Have lower health care costs Lower hospital admission and re-admission rates and lower risks for complications

5 AADE Accreditation ADA Recognition The National Standards of Diabetes Self- Management Education Define the expectations for diabetes education programs related to: Internal structure Stakeholder input Evaluation of the population served Coordination DSMES Team Members Curriculum Individualization of education On-going support Participant Progress Quality Improvement

6 AADE Accreditation ADA Recognition Programs that meet these quality standards are eligible to for a certification that designates them as qualified provider of DSMES. American Association of Diabetes Educators (AADE) Accreditation Application American Diabetes Association (ADA) Recognition

7 AADE Accreditation ADA Recognition AADE: $ per additional site for 4-year Accreditation ADA: $ $100 per additional site for 4-year Recognition Cost

8 Educational Process DSMES Programs must identify their population and devise a plan to provide DSMEs services to meet patient needs (age, income, ethnicity, education, community norms) DSMES Programs must be prepared to provide education on the following core content areas: Diabetes pathophysiology and treatment options Healthy eating Physical activity Medication usage Monitoring and using patient generated health data Preventing, detecting and treating acute and chronic complications Healthy coping with psychosocial issues and concerns Problem Solving

9 Educational Process Additional education topics are: Navigating the health care system Learning self-advocacy Content must be tailored to match the individual s needs considering Age Developmental stage, Type of diabetes Cultural factors Healthy literacy Numeracy Comorbidities

10 Educational Process Documentation must include: Initial assessment Individualized educational plan that reflects highest priority needs of the patient SMART goals Follow-up education plan Progress on SMART goals * If it isn t documented, it hasn t been done...

11 SMART Goals S = Specific M = Measurable A = Achievable R = Realistic T = Timebound Example: 1. I will walk 2 miles per day 4 x week starting. 2. I will run 10 miles per day 7 days per week. 3. I will be active (walking, swimming, cycling) for a total of 30 minutes per day 5 days per week in all months except August.

12 QUALITY Participant progress Programs must monitor and communicate whether participants are achieving their personal diabetes self-management goals or self-care behaviors. Healthy eating Being active Taking medications Monitoring Problem solving Reducing risk Healthy coping

13 DSMES Programs will also track evidence-based DSMES outcomes such as: QUALITY Program Outcomes Knowledge Behavior Clinical Quality of life Cost-savings Satisfaction outcomes

14 Communication Annual Status Report AADE and ADA report of program data during the anniversary month. Additional reports: recommended to communicate program outcomes to providers and administration as well.

15 Reimbursement Medical Nutrition Therapy( MNT) provided by a Registered Dietitian can be billed to Medicare using the RD s NPI and procedural codes: Diabetes Self-Management Training (DSMT) how Medicare refers to DSMES. Eligible for reimbursement from Medicare, using the DSMES Program s NPI number G can bill one unit for each 30 minutes 1:1 individual consultation only (not group education) 10 hours the first year and 2 hours each subsequent year Typically provided by RN, pharmacist or CDE Must enter "qualifying visit" code on claim: G0467 = FQHC visit, established pt. G0466 = FQHC visit, new pt. DSMT and MNT will not be paid by Medicare on the same day

16 MA Hodorowicz, Money Matters in DSMT 1-18

17 Consistency All DSMES Programs Policies and Procedures direct the scope of work Internal structure Stakeholder input Evaluation of population served Quality coordinator overseeing DSMES services DSMES Team Curriculum Individualization Ongoing support Particopant progress Quality improvement

18 DSMES Team Quality Coordinator Instructional Team - includes at least one of the following: Registered Nurse Registered Dietitian Pharmacist Certified Diabetes Educator Board-Certified Advance Diabetes Management Credential (BC-ADM) RN, RD, Pharmacists and members of health care disciples that can hold a certification as a CDE or BC-ADM can perform all DSMES services, including clinical assessments.* For services outside the scope of practice must have a referral source identified.

19 Summary Diabetes Self- Management Education and Support (DSMES) Evidence-based intervention that strengthens the knowledge and skills of people with diabetes to optimize their ability to selfmanage the disease. Collaborative, patient-centered Quality oriented Right for FQHCs 19

20 Questions? Jane Myers, RDN, LRD, CDE Diabetes Prevention and Control Program Director North Dakota Department of Health