Purpose The US health care system’s focus on high-quality, efficient, and cost-effective care has led payers and provider groups to identify new models with a shift toward value-based care. This perspective on clinical practice describes the population health movement and the opportunities for diabetes educators beyond diabetes self-management education, as well as steps to engage in and drive new care models to demonstrate individual, organizational, and payer value. Conclusion Diabetes educators have an opportunity to position themselves as diabetes specialists for diabetes management, education, and population health care delivery. With expertise that extends beyond diabetes self-management education and with a wide variety of skills, diabetes educators recognize that there is a range of personal, social, economic, and environmental factors that influence diabetes health outcomes. Diabetes educators should align with organizational strategic plans and support the population-level performance measures and quality initiatives, thus enhancing the value that diabetes educators bring to health care organizations.
Study Objectives: Patients visiting the emergency department (ED) commonly face delays in care that can affect patient and staff satisfaction, patient throughput and patient safety. Often these delays can be resolved with minimum resources but are challenging during times of high patient and ongoing care. The objective of our quality improvement (QI) initiative was to assemble an interdisciplinary team to identify the category, type, and location of issues within the department while improving communication and visibility of administrative staff. Once the issues were identified, the appropriate team was contacted to resolve the problem. This process required increasing communication between department leadership and staff and allowed the team to measure the time to issue resolution. Methods: This QI initiative was conducted at an academic, quaternary-care, level one trauma center with an approximate annual volume of 90,000 patients. We assembled an ED interdisciplinary team composed of the vice chair, associate chairs, nursing director, inventory coordinator, and research associates. The team rounded through each section of the department and spoke to physicians, PAs, nurses and ancillary staff to address any issues hindering patient care. The data collection sheet was optimized throughout the first month until pertinent metrics were being captured in an efficient manner. The finalized data collection sheet included inventory, information technology, equipment, patient throughput and staffing. The group contacted the appropriate team to resolve the problem and confirmed resolution during the next rounds. We documented the section of the ED where the issue arose and tracked who had been contacted to resolve it. Results: The interdisciplinary team rounded periodically from October 2018 through January of 2019 at approximately noon. We rounded a total of 40 times throughout the four months. We identified 115 issues and 61 were resolved. On average, it took 19 days to resolve issues, depending on the severity of the problem as well as which teams needed to get involved. The issues identified ranged from fixing otoscopes and lightbulbs to building a new lactation room in the department. We found that staff satisfaction improved through the employee engagement survey done 8 months apart from 80% to 89%. Conclusion: There are several factors that can impact the ability to perform daily interdisciplinary rounds which will ultimately influence the effectiveness of the rounds. We found that when we were able to perform the rounds on a consistent basis, we were more likely to have staff engaged and actual issues resolved. We also found that the resolution of these items led to faster turnaround times for our patients' care. However, the cost of administrative rounding may need to be considered when evaluating improved employee satisfaction. Some limitations were that specific issues were not resolved because the incorrect team members were assigned the tasks.
D iabetes can be a demanding and disruptive disease. Those who previously felt organized in their lives may now find themselves "situationally disorganized" due to a diabetes diagnosis. Diabetes educators can help patients get more organized and feel more in control by providing specific tools, tips, and strategies for incorporating diabetes selfcare into daily life. As diabetes educators, we passionately educate our patients on all aspects of diabetes care, including blood glucose monitoring, healthy eating, physical activity, medication management, coping skills, and stress reduction. But all of this may be undermined by a patient's lack of basic organizational and time management skills, which can significantly impede efforts to take care of diabetes on a daily basis. Organizing life with diabetes can help your patients to efficiently handle daily diabetes "must
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