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Interdisciplinary Diabetes Care Team

Caring For Diabetes | Unitypoint Health - Meriter

Caring For Diabetes | Unitypoint Health - Meriter

Living with diabetes may be challenging, but you don't have to go it alone. UnityPoint Health Meriter is committed to helping you live well with diabetes by providing coordinated care through education, coaching and support. Our Diabetes Care Team is an interdisciplinary team of Meriter providers with specialized training in diabetes management. The team is made up of specialists within endocrinology, nutrition services, health psychology and diabetes education who will work with you to create a personalized treatment plan that integrates the medical, nutritional and behavioral aspects of diabetes care. Our mission is to help you understand how you can live well with diabetes, to provide you with day-to-day skills to manage your diabetes and to empower you to make healthy lifestyle changes to achieve optimal health. Naomi Wedel, MS, RD, CD, CDE, BC-ADM - Dietitian/Certified Diabetes Educator The Diabetes Self-Management Education Programs at theWest Washington Clinic, McKee Clinicand Middleton Clinic were awarded recognition for the American Diabetes Association (ADA) in 2010. These programs were added as a multi-site to the program at Meriter, currently serving the perinatal population. Our Endocrinologists are available upon referral from any treating medical provider and they see patients at the West Washington Clinic and Deforest-Windsor Clinic . The Diabetes Care Team offers group diabetes education classes taught by our interdisciplinary providers, individual appointments based upon your specific needs, insulin pump management and support, continuous glucose monitoring and diabetes follow-up services in the clinics and by telephone. Continue reading >>

The Team Approach To Intensive Diabetes Management

The Team Approach To Intensive Diabetes Management

Behavioral scientists (psychologists, social workers, psychiatrists, or other mental health professionals) play a pivotal role on the team by identifying barriers to diabetes self-management, providing assistance in setting treatment goals, and helping patients implement the management skills needed for intensive diabetes treatment. Behavioral scientists also provide counseling services regarding adjustment to chronic illness and stress management, diagnose psychiatric illness, and screen for learning disorders that might interfere with patient comprehension and compliance. Interdisciplinary team care requires the adoption of a shared professional identity.15 In the traditional medical model, professionals from each discipline approach diabetes treatment from their own professional paradigm. In interdisciplinary care, however, members share a common professional identity as a part of the team, as well as a common purpose. Having a shared professional identity does not suggest that members give up their unique contributions as physician, nutritionist, nurse, or behavioral scientist. Rather, all members bring specific expertise and a valuable point of view to the group. It does, however, call for tolerance and even encouragement of flexible roles within a team. One example of nontraditional roles within a team setting would be having insulin adjustments made by a nurse, dietitian, or patient, rather than by a physician.18 Routine physical examinations and screening for complications may be provided by a nurse or medical assistant.18-20 This does not suggest that team members exceed their scope of practice, but it does require that all members have a thorough understanding of diabetes and its management, be skilled in helping patients identify barriers to self-management, Continue reading >>

Improving Outcomes Through A Coordinated Diabetes Disease Management Model

Improving Outcomes Through A Coordinated Diabetes Disease Management Model

Improving Outcomes Through a Coordinated Diabetes Disease Management Model Cristi L. Day, DNP, RN, FNP-C, ADM-BC 1 Susan Kimble, DNP, RN, ANP-BC 2 An-Lin Cheng, PhD 2 Annals of Long-Term Care: Clinical Care and Aging. 2014;22(9):38-44. 1College of Nursing & Health Sciences, Texas A&M University, Corpus Christi, TX 2School of Nursing & Health Studies, University of Missouri, Kansas City, MO Abstract: Nursing home residents are often medically complex, and there is a high prevalence of diabetes mellitus in the presence of one or more acute conditions. Outcomes for this patient population have been shown to improve with an interdisciplinary team approach to disease management. The authors conducted a quality improvement initiative that sought to measure and improve diabetes outcomes in a long-term care population at a corporately owned 112-bed nursing home located in South Texas. The team implemented evidence-based care using a specialized nurse practitioner within the coordinated diabetes disease management (CDDM) model. The AMDA The Society for Post-Acute and Long-Term Care Medicine (formerly the American Medical Directors Association) evidence-based diabetes guidelines were employed for clinical decision-making. The authors found that their project led to significant improvements in patient outcomes, including reductions in hypoglycemia incidence and sliding scale insulin orders, while increasing resident-centered care and improving chronic kidney disease screenings. Nursing home residents with diabetes represent a heterogeneous population; thus, implementation of patient-centered disease management strategies is essential to improving outcomes and quality of life in this population. Use of a specialized healthcare practitioner to coordinate interdisciplinary diabetes Continue reading >>

The Interdisciplinary Approach To The Implementation Of A Diabetes Home Care Disease Management Program

The Interdisciplinary Approach To The Implementation Of A Diabetes Home Care Disease Management Program

The Interdisciplinary Approach to the Implementation of a Diabetes Home Care Disease Management Program February 2014, Volume 32 Number 2 , p 108 - 116 This article has an associated Continuing Education component. Expires February 28, 2019. Go to CE Details Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life. Diabetes Mellitus: The Enormity of the Epidemic Diabetes affects nearly 26 million people of all ages (Centers for Disease Control and Prevention [CDC], 2011). Nearly 10% of the entire U.S. population has diabetes, including more than 25% of seniors (CDC, 2011). An estimated 79 million American adults have prediabetes, of which 50% are 65 years and older (CDC, 2011). As many as one in three American adults are projected to have diabetes in 2050 if present trends continue (CDC, 2011). Diabetes contributes to direct and indirect healthcare costs, morbidity, and mortality. It is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States ( American Diabetes Association [ADA], 2011 ). Diabetes is a major cause of heart disease and stroke, and is the seventh leading cause of death in the United States (ADA, 2011). Diabetes kills more Americans every year than AIDS and breast cancer combined (ADA, 2011). In the United States, approximately 5% of the population with diagnosed diabetes has been diagnosed with Type 1 diabetes; approximately Continue reading >>

Building An Effective Diabetes Care Team

Building An Effective Diabetes Care Team

No one can effectively manage diabetes alone, whether you have the disease or you're a physician caring for someone with it. "Its been known for years that diabetes requires a multidisciplinary team approach because there are so many components to its management," says Martin Abrahamson, M.D., Medical Director and Senior Vice President at Joslin Diabetes Center. This core team provides individualized care based on your needs, taking into account clinical guidelines developed at Joslin and other organizations. Your team meets regularly to review your progress. As someone with diabetes, you are the most important member of the team. You help set goals and members of your team provide the education and support necessary for you to achieve them. If youve just been diagnosed, your physician may refer you to Joslin just for education (individual appointments, group classes , or both). Or you can make an appointment directly with a Joslin physician. At your first appointment, you'll meet with both a physician and a certified diabetes educator. Meeting with these two experts is necessary because the medical and educational management of diabetes go hand in hand, points out Dr. Abrahamson. As the need arises, other specialists are brought onto the team: an ophthalmologist (eye care), nephrologist (kidney health), cardiologist (cardiovascular disease prevention), or podiatrist (foot care), for example. As the need arises, other specialists are brought onto the team: an ophthalmologist (eye care), nephrologist (kidney health), cardiologist (cardiovascular disease prevention), podiatrist (foot care) for example. A team effort keeps the score against diabetes in your favor. Continue reading >>

Multidisciplinary Care Teams In Diabetes Management

Multidisciplinary Care Teams In Diabetes Management

Multidisciplinary Care Teams in Diabetes Management Multidisciplinary Care Teams in Diabetes Management What Are the Benefits of Using a Care Team? Diabetes affects 9.3% of the US population and is associated with an estimated financial burden of $245 billion.1 In caring for this costly, chronic condition, it is important for health care providers to consider all aspects of a patients life. Implementation of a diabetes care team ensures that all necessary behavioral, dietary, lifestyle, and pharmaceutical interventions are implemented, and can improve the overall quality of diabetes care.2 Positive Outcomes Associated With Care Teams In a 2006 meta-analysis published in JAMA investigating the impact of strategic quality improvement on glycemic control among adults with type 2 diabetes, researchers found that the use of multidisciplinary care teams, shared care between primary care physicians and specialists, and effective case management led to reductions in HbA1c by at least 0.5%.3 Additional positive outcomes of care team management include increased patient satisfaction, improved quality of life, fewer hospitalizations, decreased health care costs, and lower risks for diabetes complications.1 The National Diabetes Education Program (NDEP) highlights 3 models that can be effective when caring for patients with chronic diseases like diabetes: the chronic care model, the medical home model, and the healthy learner model.1 In the 2016 update of the American Diabetes Associations (ADA) Standards of Medical Care in Diabetes2 the ADA notes that the chronic care model has been shown to be an effective framework for improving the quality of diabetes care. The models focus on collaborative, multidisciplinary teams provide Continue reading >>

Interdisciplinary Diabetes Care Teams Operating On The Interface Between Primary And Specialty Care Are Associated With Improved Outcomes Of Care: Findings From The Leuven Diabetes Project

Interdisciplinary Diabetes Care Teams Operating On The Interface Between Primary And Specialty Care Are Associated With Improved Outcomes Of Care: Findings From The Leuven Diabetes Project

Borgermans et al; licensee BioMed Central Ltd.2009 Type 2 diabetes mellitus is a complex, progressive disease which requires a variety of quality improvement strategies. Limited information is available on the feasibility and effectiveness of interdisciplinary diabetes care teams (IDCT) operating on the interface between primary and specialty care. A first study hypothesis was that the implementation of an IDCT is feasible in a health care setting with limited tradition in shared care. A second hypothesis was that patients who make use of an IDCT would have significantly better outcomes compared to non-users of the IDCT after an 18-month intervention period. A third hypothesis was that patients who used the IDCT in an Advanced quality Improvement Program (AQIP) would have significantly better outcomes compared to users of a Usual Quality Improvement Program (UQIP). This investigation comprised a two-arm cluster randomized trial conducted in a primary care setting in Belgium. Primary care physicians (PCPs, n = 120) and their patients with type 2 diabetes mellitus (n = 2495) were included and subjects were randomly assigned to the intervention arms. The IDCT acted as a cornerstone to both the intervention arms, but the number, type and intensity of IDCT related interventions varied depending upon the intervention arm. Final registration included 67 PCPs and 1577 patients in the AQIP and 53 PCPs and 918 patients in the UQIP. 84% of the PCPs made use of the IDCT. The expected participation rate in patients (30%) was not attained, with 12,5% of the patients using the IDCT. When comparing users and non-users of the IDCT (irrespective of the intervention arm) and after 18 months of intervention the use of the IDCT was significantly associated with improvements in HbA1c, LDL-c Continue reading >>

Adea | Multidisciplinary Diabetes Care

Adea | Multidisciplinary Diabetes Care

Multidisciplinary diabetes care is a team approach to providing diabetes support, education and care. Multidisciplinary diabetes care: Demonstrates shared leadership, accountability and responsibility for individualised planning of services and support to improve the quality of life for the person with diabetes Is comprehensive, holistic and integrated across the lifespan needs of people with diabetes Is a collaborative team effort of health care professionals who are respectful and accepting of each others discipline specific skills, training, attributes and contribution to diabetes care Supports shared decision-making by valuing and respecting the contributions of each member of the diabetes team; the person with diabetes, their family or carer and other health care professionals Development of pathways and protocols for treatment and care Development of appropriate referral networks, including appropriate pathways to meet psychosocial needs Development of multidisciplinary team audit mechanisms The person with diabetes must consent priorto their case being discussed by the diabetes team Improved treatment planning and thus improved outcomes for people with diabetes and their families and carers Better detection and management of the psychosocial and emotional needs of people with diabetes and their family or carers Improved information sharing between the diabetes team member Who are the members of the diabetes team? Who participates depends on the type of diabetes, the services available in the particular location, the health care setting (primary care or tertiary sector), and the stage of diabetes and the needs of the person with diabetes. In addition to the person with diabetes and their family or carer, the following are commonly long term members of the diabete Continue reading >>

The Interdisciplinary Team In Type 2 Diabetes Management: Challenges And Best Practice Solutions From Real-world Scenarios

The Interdisciplinary Team In Type 2 Diabetes Management: Challenges And Best Practice Solutions From Real-world Scenarios

The interdisciplinary team in type 2 diabetes management: Challenges and best practice solutions from real-world scenarios Margaret McGill ,a Lawrence Blonde ,b, Juliana C.N. Chan ,c Kamlesh Khunti ,d Fernando J. Lavalle ,e Clifford J. Bailey ,f and The Global Partnership for Effective Diabetes Management, on behalf of bOchsner Diabetes Clinical Research Unit, Frank Riddick Diabetes Institute, Department of Endocrinology, Ochsner Medical Centre, New Orleans, LA, USA cDepartment of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China aDiabetes Centre, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia bOchsner Diabetes Clinical Research Unit, Frank Riddick Diabetes Institute, Department of Endocrinology, Ochsner Medical Centre, New Orleans, LA, USA cDepartment of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China dLeicester Diabetes Centre, University of Leicester, Leicester, UK eDepartamento de Medicina Interna, Hospital Universitario Dr. Jos Eleuterio, Universidad Autnoma de Nuevo Len, Monterrey, Mexico fSchool of Life and Health Sciences, Aston University, Birmingham, UK Corresponding author at: Department of Endocrinology, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, 70121 LA, USA.Department of EndocrinologyOchsner Medical Center1514 Jefferson HighwayNew Orleans70121 LAUSA [email protected] Received 2016 Oct 17; Revised 2016 Dec 1; Accepted 2016 Dec 2. This is an open access article under the CC BY-NC-ND license (The Global Partn Continue reading >>

My Site - Chapter 6: Organization Of Diabetes Care

My Site - Chapter 6: Organization Of Diabetes Care

Diabetes care should be organized around the person living with diabetes who is practising self-management and is supported by a proactive, interprofessional team with specific training in diabetes. Diabetes care should be delivered using as many elements as possible of the chronic care model. The following strategies have the best evidence for improved outcomes and should be used: promotion of self-management, including self-management support and education; interprofessional team-based care with expansion of professional roles, in cooperation with the collaborating physician, to include monitoring or medication adjustment and disease (case) management, including patient education, coaching, treatment adjustment, monitoring and care coordination. Diabetes care should be structured, evidence based and supported by a clinical information system that includes electronic patient registries, clinician and patient reminders, decision support, audits and feedback. Recognize: Consider diabetes risk factors for all of your patients and screen appropriately for diabetes. Register: Develop a registry for all of your patients with diabetes. Resource: Support self-management through the use of interprofessional teams which could include the primary care provider, diabetes educator, dietitian, nurse, pharmacist and other specialists. Relay: Facilitate information sharing between the person with diabetes and the team for coordinated care and timely management changes. Recall: Develop a system to remind your patients and caregivers of timely review and reassessment. In Canada, there is a care gap between the clinical goals outlined in evidence-based guidelines for diabetes management and real-life clinical practice (1,2) . Since almost 80% of the care of people with diabetes takes pl Continue reading >>

A Team For Every Patient With Diabetes An Interdisciplinary Approach To A Complex, Chronic Disease

A Team For Every Patient With Diabetes An Interdisciplinary Approach To A Complex, Chronic Disease

A team for every patient with diabetes An interdisciplinary approach to a complex, chronic disease Diabetes Mellitus is a chronic illness that requires a lifelong commitment to complex lifestyle modifications involving nutrition management, physical activity, regular self-blood glucose monitoring, and adherence to medications and/or insulin therapy. Proper management of these lifestyle modifications has been shown to reduce the risk and progression of diabetes complications. However, achieving and sustaining effective management is a huge challenge and more than half of those living with diabetes in Canada are unable to meet the recommended targets for glycemic control. The majority of Canadians are receiving diabetes care solely from their primary care physicians. However, family physicians themselves have expressed concern with having sole responsibility for patients with diabetes. Managing diabetes over a patients entire life requires a lot of time and frequent visits to deal with the complex individual needs of each patient. To most effectively manage diabetes, and to prevent or delay its complications, patients require the ongoing support of an interdisciplinary team of specialists. However, barriers often exist in accessing interdisciplinary services, and these services are required often repeatedly over a long period of time. Trillium Health Centre, a community-based specialty hospital serving Mississauga and west Toronto, uses a multidisciplinary model and provides on-site one stop shopping for patients. The Diabetes Management Centre (DMC), part of Trilliums GlaxoSmithKline Chronic Disease Management & Prevention Centre, has a team of over 40 staff. DMC patients have access to four endocrinologists, registered nurses, registered dietitians, foot care nurses, a Continue reading >>

Team Carethe Preferred Approach To Diabetes Treatment

Team Carethe Preferred Approach To Diabetes Treatment

Team CareThe Preferred Approach to Diabetes Treatment US Endocrinology, 2015;11(2):756 DOI: Diabetes requires the person living with the disease to make daily healthcare decisions. Research shows that a team approach is an effective way to help people better manage their diabetes. Teams that include a diabetes educator offer access to education, improved glycemic control, quality of life, and decreased risk for complications and healthcare costs. The provision of team care and self-management education offers a solution and can be a viable model in overcoming the barriers associated with the complexities of diabetes care. Keywords: Team care, diabetes education, improved outcomes Disclosure: Linda Siminerio, RN, PhD, CDE, has no conflicts of interest to declare. No funding was received for the publication of this article. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. Received: July 22, 2015 Accepted September 28, 2015 Correspondence: Linda Siminerio, RN, PhD, CDE, University of Pittsburgh Diabetes Institute, Falk Medical Building, Room 562, 3601 Fifth Avenue, Pittsburgh, PA 15213, US.E: [email protected] Diabetes is a lifestyle disease that requires the person living with the disease to make many daily decisions about diet, activity level, and medications, as well as adequate support to manage the disease successfully. Research has shown that a team-based approach to diabetes care is an effective way to help people with diabetes manage the disease, prevent and treat complications, provide behavior-change strategies, and cope with the emotional challenges this chr Continue reading >>

Health Care Team

Health Care Team

Diabetes is best managed with the support of a diabetes healthcare team. The team approach will help you learn everything you need to know about diabetes, treatment and management. Many people can be part of your health care team to help you live well with diabetes. Your team can be made up of health professionals as well as your family and friends. But you are the most important member. You make the day-to-day decisions about your diabetes, and the more you know about diabetes, the easier this will be. The following are the kinds of people you may wish to have in your health care team. Talk to your doctor about what is right for you. When you are first diagnosed, your family doctor is the best doctor to see first. If you don’t have a family doctor then any general practitioner will be able to help you. Your doctor has a central role in assessing your diabetes and helping you manage it. They can refer you to any specialists that you may need to see. A Credentialled Diabetes Educator (CDE) will work with you to help you understand and manage your diabetes. They can provide a wide range of general information about diabetes and associated complications. Your doctor can refer you to a CDE in your area, or you can find a CDE on the Australian Diabetes Educators Association website, or your local hospital, diabetes centre and community health centres which are listed in the telephone directory, may have a CDE. A dietitian will work with you to develop a personalised healthy eating plan to suit your lifestyle, your type of diabetes and individual health needs. They can teach you how to read food labels, modify recipes and even how to order at restaurants. Contact the Dietitians Association of Australia on 1800 812 942, or contact your local hospital (not all hospitals have Continue reading >>

The Common Characteristics And Outcomes Of Multidisciplinary Collaboration In Primary Health Care: A Systematic Literature Review

The Common Characteristics And Outcomes Of Multidisciplinary Collaboration In Primary Health Care: A Systematic Literature Review

The common characteristics and outcomes of multidisciplinary collaboration in primary health care: a systematic literature review Authors: Sanneke Schepman,Johan Hansen,Iris D. de Putter,Ronald S. Batenburg,Dinny H. de Bakker Introduction:Research on collaboration in primary care focuses on specific diseases or types of collaboration. We investigate the effects of such collaboration by bringing together the results of scientific studies. Theory and methods:We conducted a systematic literature review of PubMed, CINAHL, Cochrane and EMBASE. The review was restricted to publications that test outcomes of multidisciplinary collaboration in primary care in high-income countries. A conceptual model is used to structure the analysis. Results:Fifty-one studies comply with the selection criteria about collaboration in primary care. Approximately half of the 139 outcomes in these studies is non-significant. Studies among older patients, in particular, report non-significant outcomes (p< .05). By contrast, a higher proportion of significant results were found in studies that report on clinical outcomes. Conclusions and discussion:This review shows a large diversity in the types of collaboration in primary care; and also thus a large proportion of outcomes do not seem to be positively affected by collaboration. Both the characteristics of the structure of the collaboration and the collaboration processes themselves affect the outcomes. More research is necessary to understand the mechanism behind the success of collaboration, especially on the exact nature of collaboration and the context in which collaboration takes place. Many countries stimulate collaboration between different disciplines in primary care and between primary care and other sectors [ 1 ]. There is a general agree Continue reading >>

Inpatient Diabetes Care Process Team Improves Outcomes

Inpatient Diabetes Care Process Team Improves Outcomes

Texas Childrens Hospital is improving the care delivery of its patients with diabetes, one of the most common diseases in schoolaged children. How? Powered by dedicated improvement teams and analytics, they have focused on order utilization, timeliness of IV and subcutaneous insulin administration, length of stay (LOS), establishing a diabetic care unit (DCU), educating core diabetic nurses (CDNs), frontline staff adoption, and more. Care delivery improvements include the following: 94 percent of patients with diabetic ketoacidosis (DKA) are assigned to diabetic care unit. 17 percent relative increase in patients with DKA receiving an evidence-based evaluation and order sets. 19 percent relative increase in patients with DKA receiving IV insulin within one hour of order. 50 percentage point improvement in the percentage of patients transitioning to SubQ insulin in less than four hours after medical readiness. 44 percent relative decrease in LOS for patients with DKA. Diabetes mellitus is one of the most common diseases in school-aged children. In fact, in 2012, more than 200,000 young people in the United States under age 20 suffered from the disease.1 Unfortunately, the number of children and adolescents in the U.S. with type 1 or type 2 diabetes is increasing.2 This growing incidence of diabetes has significant ramifications for childrens long-term health, since the disease at least doubles a persons risk of early death.3 It also poses a real quality and cost challenge for hospitals. Diabetes can be difficult to manage in the hospital because acute illness, surgery, and changes in daily routines can affect blood glucose levels.4 Furthermore, diabetes patients are at risk for serious complications, longer hospital stays, and poorer outcomes.5 A particularly complex an Continue reading >>

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