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QIN-QIO Public Sharing Call – Understanding the 2017 National Standards for Diabetes Self- Management Education and Support Wednesday September 26, 2018 3:00-4:30 PM ET

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Page 1: QIN-QIO Public Sharing Call – September 26, 2018 · 9/26/2018  · QIN-QIO Public Sharing Call – ... services in meeting and maintaining recognition or accreditation. • Describe

QIN-QIO Public Sharing Call –Understanding the 2017 National Standards for Diabetes Self-Management Education and Support

Wednesday September 26, 20183:00-4:30 PM ET

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Welcome and Reminders

Karen Ten CateEvent Lead

Lindsay KaatzChat Manager

• Please be prepared for sharing and open discussion

• Slides and a recording from today’s session can be found on: https://qioprogram.org/qin-qio-public-sharing-call-september-2018

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Purpose

• Audience: Patients, community and healthcare providers, local partners, federal partners, and Quality Improvement Organization (QIO) Program partners (*registration required)

• Purpose: The purpose of this session is to prepare healthcare quality improvement professionals to identify and implement effective healthcare strategies by exploring the 2017 National Standards for Diabetes Self-Management Education and Support

• Expectations: Participants will gain knowledge that is directly applicable to their work in healthcare quality improvement and acquire information that can be easily shared among their own community, organization, or team

• Topics: Topics will be aligned with the CMS Quality Strategy goals

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Learning Outcomes

• Identify the initial and annual requirements for ADA recognition or AADE accreditation of diabetes self-management education and support (DSMES) services.

• Be able to set an action plan to transition to an ADA recognized or AADE accredited DSMES service.

• List the annual requirements of professional and paraprofessional DSMES team members.

• List 3 ADA and 3 AADE resources that assist DSMES services in meeting and maintaining recognition or accreditation.

• Describe the difference between a DSMES behavioral goal and a diabetes self-management support plan.

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Things to Think About

Will you commit to being… • Attentive• Active• Actionable

Show your commitment by clicking the green checkmark!

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Let’s Take a Poll

How familiar are you with the 2017 National Standards of Diabetes Self-Management Education and Support?

a. Not at all familiar b. I’ve seen them at least once c. Refer to when needed, but unsure of some standards d. I live by them (very familiar)

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Continuing Education Credit

Continuing education credit is available for:• Physicians and Physician Assistants• Registered Nurses and Nurse Practitioners• Dietitians• Pharmacists and Pharmacy Technicians• Certificate of Attendance

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Instructions for Obtaining CE

• Attend the entire event• Complete the evaluation that will pop up at the

conclusion of the event• There is a separate evaluation required for CE that will

load in your browser following completion of the general evaluation

• Once you submit your CE evaluation, you will be provided with a certificate to retain for your records

• For technical assistance, please email Stacey Davis ([email protected])

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CE Information

Physicians:This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providershipof AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.

AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants:NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.

Pharmacists:AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.AKH Inc., Advancing Knowledge in Healthcare approves this knowledge-based activity for 1.5 contact hours (0.15 CEUs). UAN 0077-9999-18-031-L04-P; UAN 0077-9999-18-031-L04-T. Initial Release Date 9/26/2018

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CE Information, Continued

Registered Nurses:AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.This activity is awarded 1.5 contact hours.

Nurse Practitioners:This activity has been planned and implemented in accordance with the accreditation Standards of the American Association of Nurse

Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803This activity is accredited for 1.5 contact hour(s) which includes 0 hour(s) of pharmacology. Activity ID #218176

Dietitians:AKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.5 continuing professional education units (CPEUs) for completion of this program/material. CDR Accredited Provider #AN008. The focus of this activity is rated Level 2. Learners may submit evaluations of program/materials quality to the CDR at www.cdrnet.org.

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Disclosure of Financial Relationships & Commercial Support

• The planners and faculty do not have any relevant financial relationships to disclose.

• AKH Inc., CRW & Associates, and Telligen do not have any relevant financial relationships to disclose.

• No commercial support was received for this activity.

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Disclosure of Financial Relationships & Commercial Support

Disclosures:It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whoseproducts or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral toNational Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.

Disclosure of Unlabeled Use and Investigational Product:This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Pleaserefer to the official prescribing information for each product for discussion of approved indications, contraindications, andwarnings.

Disclaimer:This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as ageneral guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or otherprofessional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.

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Method of Participation

• You must participate in the entire activity to receive credit.

• A statement of credit will be available upon completion of an online evaluation/claimed credit form.

• The link to the online evaluation will be provided after completion of the activity.

• If you have questions about this CME/CE activity, please contact AKH Inc. at [email protected].

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Meet Your Speakers

Jodi Lavin-Tompkins, MSN, RN, CDE, BC-ADM

Director of AccreditationAmerican Association of Diabetes

Educators

Uzma Quraishi, MS, RDAssociate Director, Education

Recognition ProgramAmerican Diabetes Association

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Disclosure to Participants Notice of Requirements For Successful Completion

Please refer to learning goals and objectives Learners must attend the full activity and complete the evaluation in order

to claim continuing education credit/hours Conflict of Interest (COI) and Financial Relationship Disclosures

Presenter: Jodi Lavin-Tompkins MSN, RN, CDE, BC-ADM – No conflicts of interest to disclose

Presenter: Uzma Quraishi MS, RD– No conflicts of interest to disclose Non-Endorsement of Products

Accredited status does not imply endorsement by ADA, AADE, ANCC, ACPE or CDR of any commercial products displayed in conjunction with this educational activity

Off-Label Use Participants will be notified by speakers to any product used for a purpose

other than for which it was approved by the Food and Drug Administration.

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Learning Objectives Identify the initial and annual requirements for AADE accreditation or

ADA recognition of DSMES services.

Be able to set an action plan to transition to an ADA Recognized or AADE Accredited DSMES service.

List the annual requirements of professional DSMES and paraprofessional DSMES team members.

List 3 ADA and 3 AADE resources that assist DSMES services in meeting and maintaining accreditation

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Introductionand

Accreditation/Recognition Overview

Jodi Lavin-Tompkins MSN, RN, BC-ADM, CDE

Director of Accreditation

American Association of Diabetes Educators

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ADA and AADE are the two CMS National Accrediting Organizations for DMST

[email protected]/erp

[email protected]

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Accreditation/Recognition 4 Year Cycle Online application and fee submission Supporting documents for all standards plus onede-identified patient chart

Once accredited/recognized, receive certificate to provide a copy to MAC (Medicare Administrative Contractor) Every year following accreditation, need to report data,

stakeholder input, continuous quality improvement plan/results Be audit ready at all times Every 4 years need to re-apply/renew

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Operationalizing the Diabetes Self-Management

andSupport Standards

Jodi Lavin-Tompkins MSN, RN, BC-ADM, CDE

Director of Accreditation

American Association of Diabetes Educators

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There are 10 National Standards to meet for accreditation

Structure Standards

Standard 1 –

Internal Structure

Standard 2 –

Stakeholder Input

Standard 3 –

Evaluation of population served

Standard 4 –

Quality Coordinator overseeing DSMES

Process Standards

Standard 5 –

DSMES Team

Standard 6 –

Curriculum

Standard 7 –

Individualization

Standard 8 –

Ongoing Support

Outcome Standards

Standard 9 –Participant ProgressStandard 10 –Quality Improvement

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AADE Interpretive GuidanceHighlights from the standards

document.

The element of a standard that

a DSMES service must

have operationalized

for Accreditation

The documented

evidence that reflects adherence

to the standard

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ADA Review Criteria and Indicators

The element of a standard that

a DSMES service must have

operationalized for Recognition

The documented

evidence that reflects

adherence to the standard

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Standards Walk Through

ADA or AADEReflects requirements unique

to one or the other organizations

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AWalk Through Standards 1-5

Jodi Lavin-Tompkins MSN, RN, CDE, BC-ADM

Director of Accreditation

American Association of Diabetes Educators

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Standard 1: Mission and Goals Organizational Structure/Org Chart illustrating where

the DSMES service fits into the larger organization

Mission Statement = fundamental purpose

Program Goals = activities to accomplish the mission

Signed letter of support from sponsoring organization/owner

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Standard 2: Stakeholder Input Process for seeking outside input and lists the

stakeholders, roles Documented at least annually and available for audit Must document within 6 months after accreditation if not

submitted with application (AADE) Stakeholders can give input to improve utilization,

quality, measureable outcomes, and sustainability of the services Input can be completed by phone, survey, email, or face-

to-face ADA requires single discipline services to have a

healthcare provider of a different discipline as a stakeholder

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Standard 3: Evaluation of Population Served

Evaluating the population where services are delivered determines the resources, design and delivery methods that will align with their needsDocument allocation of resources to meeting

population specific needs Document plan to address any opportunities, gaps

in services, access issues identified

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Standard 4: Quality Coordinator Overseeing DSMES Services

Quality Coordinator is responsible for all components of DSMES, including evidence-based practice, service design, evaluation and continuous quality improvement Coordinator resume/CV Coordinator job description 15 hours of Continuing Education related to diabetes

within 12 months prior to the application and annually throughout the 4 years OR maintenance of CDE or BC-ADM certification

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Standard 5: DSMES Team At least one team member is an RN, RD or pharmacist with

training and experience pertinent to DSMES, or be another health care professional holding CDE or BC-ADM certification All team members have valid licensure, registration and

certification Team members have either 15 hours of continuing education

annually OR maintain CDE or BC-ADM certification Paraprofessionals may contribute with appropriate training and

supervision must have experience or training in related field, is

supervised by Quality Coordinator/professional team member, has annual documentation of 15 hours of continuing education and/or training specific to the role they serve on the team

Document explaining a mechanism for ensuring participant needs are met if outside scope of practice or expertise

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Q & A on the first five Standards

• Standard 1: Mission and Goals• Standard 2: Stakeholder Input• Standard 3: Evaluation of Population Served• Standard 4: Quality Coordinator Overseeing DSMES

Services• Standard 5: DSMES Team

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A Walk ThroughStandards 6 - 10

Uzma Quraishi MS, RDAssociate Director of Education Recognition

Program for the American Diabetes Association

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Standard 6: CurriculumDocumentation reflecting: A service’s curriculum with 9 topic areas

Diabetes pathophysiology and treatment optionsHealthy eatingPhysical activityMedication useMonitoring and using patient generated health data (PGHD)Preventing, detecting, and treating acute complicationsPreventing, detecting, and treating chronic complicationsHealthy coping with psychosocial issues and concernsProblem solving

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Standard 6: Curriculum 2 of the 9 Topic Areas must reflect specific elements

Preventing, detecting, and treating acute complications including hypoglycemia, hyperglycemia, diabetes ketoacidosis, sick day guidelines, and severe weather or situation crisis and diabetes supplies management

Preventing, detecting, and treating chronic complications including immunizations and preventive eye, foot, dental, and renal examinations as indicated per the individual participant’s duration of diabetes and health status

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Page 35: QIN-QIO Public Sharing Call – September 26, 2018 · 9/26/2018  · QIN-QIO Public Sharing Call – ... services in meeting and maintaining recognition or accreditation. • Describe

Standard 6: Curriculum

Documentation reflecting:

Each of the 9 topic areas must have:ContentLearning objectivesMethods of deliveryCriteria for evaluating learning for population served

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Standard 6: Curriculum

Supporting material relevant to the population served

Regular review and/or revisions as needed or at least annually of the curriculum and/or supporting materials by DSMES team members and/or advisory group

The instruction method is tailored/individualized and involves problem solving

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Standard 7, 8, and 9: The DSMES Chart

Standard 7: Individualization

Standard 8: Ongoing Support

Standard 9: Participant Progress

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The DSMES Assessment An Assessment in the following 12 areas is required.

Diabetes disease processNutrition managementPhysical activityUsing medicationsMonitoring blood glucosePreventing, detecting, and treating acute complicationsPreventing detecting, and treating chronic complicationsCognitive (knowledge of self-management skills, functional health literacy)Psychosocial (emotional response to diabetes)

Clinical (diabetes and other pertinent clinical history)Diabetes distress and support systemsBehavioral (readiness for change, lifestyle practices, self-care behaviors)

If part of the assessment is deferred, the reason for deferment needs to be documented.

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The Participant Education Record

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The Participant Education Record

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The Support Plan (DSMS Plan) DSMES participants’ self selected Diabetes Self-Management Support plan

ADA DSMS Plan must be outside of the DSMES service

List of support options, including those specific to community

The support options being reviewed/revised at least annually

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Outcome Measurement and Communication

Participants’ achievement of at least one of their individualized self selected behavior goals At least one other participant outcomeOutcome assessments are personalized and reviewed at appropriate intervalsCommunication with referring provider (if applicable) or with another healthcare provider outside of the DSMES services regarding the education planned or provided and participant outcome

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Standard 10: Quality Improvement Aggregation of at least one participant behavioral goal

Aggregation of at least one other participant outcome

New DSMES services: A continuous quality improvement (CQI) project plan AADE-for new services, review requirements on phone

interview and do a check-in at 6 months Existing services: A current CQI project

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Standard 10: Quality Improvement A CQI project that includes:Opportunity for DSMES service improvement or changeBaseline project achievement*Project targetOutcome assessment and evaluation scheduleCQI outcomes measured at a minimum annuallyPlans and actions based on CQI outcomes*

* - items new services may not have at the time of their application

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ADA ResourcesQuality Coordinator Guide CQI Toolkit ERP Live Symposiums (7.25 CEUs)Monthly and Quarterly Q and A networking callsNew QC Call , Application and Annual Status Report Call, Chronicle Diabetes DSMES Charting Platform Call, DPP Charting Platform Call, KRAMES Call, Expanding ERPs to the Primary Care Quarterly Call, DSMES at FQHC)

• Krames Health Sheets • 3,000 sheets in English and Spanish and 10 other languages• Arabic Korean Armenian Portuguese Chinese Russian Farsi Tagalog French

Vietnamese

www.diabetes.org/[email protected]

1.888.232.082251

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AADE Resources [email protected]

• Interpretive Guidance• Online application

Dashboard• Phone interview for all new

applicants• Monthly coordinator

webinars• One year free membership

with accreditation (20 free CEU’s)

• Access to Reimbursement Expert

• New: DANA tech hub• New: Quality

Coordinator Practice Discussion Group on myAADE network

Webinars WorkshopsWorkforce trainingOnline CE courses Books AADE7 self-care behavior tip sheets patient handouts videos AADE7system software Annual ConferenceDPP resources and software

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Facilitated Discussion

Chat in your questions and comments.

Press *1 on your telephone key pad to enter the teleconference queue.

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Call to Action

• What is one Standard you will start work on in the next week? Please chat in.

• What resource(s) you will access to fulfill this requirement.

–Leadership, internal program staff, IT department, external stakeholders

–Specific ADA or AADE guidance documents–Technical assistance (QIN-QIO, ADA, AADE)

• https://qioprogram.org/locate-your-qio

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CE Credit

• Complete the post-event assessment upon exiting WebEx: https://www.surveymonkey.com/r/ZD83F2C

• It will pop up at the conclusion of the event• There is a separate evaluation required for CE that will

load in your browser following completion of the general evaluation

• Once you submit your CE evaluation, you will be provided with a certificate to retain for your records

• For technical assistance, please email Stacey Davis ([email protected])

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Save the Date!

Join us for the Three-Part QIN-QIO Public Sharing Call Series: Going Back to Basics of Diabetes Self-Management Training

– The 2nd Thursday of October, November, and December– Topics: operations, reimbursement, and CQI for DSME/T

programs– 3:00 - 4:30 PM ET– Registration is required!

• Register at https://qioprogram.org/qin-qio-public-sharing-calls-3-part-series

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Follow the QIO Program on Social Media!

https://twitter.com/QIOProgram

https://www.youtube.com/channel/UCP-3KliHRoKeozEs-7ohQnw

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Thank you!

This material was prepared by Telligen, the Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-QINNCC-02324-09/19/18

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