logo

How the New Position Statement Will Rekindle Your Passion for DSME/S



Barbara EichorstAfter the American Diabetes Association's 75th Scientific Sessions, I came back to work with renewed focus and excitement for self-management education and support.

A new position statement on diabetes self-management education and support (DSME/S) in type 2 diabetes was presented at the conference. It provided updated validation for DSME/S.

The position statement backs up our belief in DSME/S by:

1. Headlining it: it works!
2. Backing it up with facts: it works as well as medication
3. Humanizing it: it improves the lives of our patients
4. Bottom-lining it: all people with diabetes need DSME/S

I also learned that despite the wonders of DSME/S and its growing accessibility, less than 7% of eligible patients pursue DSME/S within the first 12 months of their diagnosis.1

The updated guidelines include evidence supporting DSME/S as well as a decision support tool that recommends four critical times to assess, provide, and adjust diabetes self-management education and support. I am energized by the potential for this tool to be used to train care teams and increase referrals into DSME/S. We will talk more about how it might be used in another post.

For those patients who are accessing DSME/S, the paper reminded me how important our role is in delivering patient-centered care. People with diabetes are faced with incorporating very complex care activities into their daily routine, and we healthcare professionals are here to educate, support, and motivate patients and their support network.

The paper provides guiding principles and key elements for initial and ongoing DSME/S. The very first section of guidelines and elements is "Engagement" while "Information Sharing" is second on the list. To me, this was an important reminder that the care team providing DSME/S to a diabetes patient should try to approach each patient as an individual with complex and unique needs. The healthcare team's goal is to remain solutions-neutral, authentically engage with the patient, and save time to attend to psychosocial support. Delivering on engagement as a top priority will require the care team to have not just disease management knowledge, but skills related to active listening, self-efficacy, and behavior change.

To keep up with the evolution of optimal delivery of DSME/S, it is important to continually work on our patient-centered skills. I know in my practice, I try to actively work on focusing on engagement and not just telling patients what I think they need to know. I am an advocate for patient engagement and yet when the pressures of the day weigh on me, even I struggle. I've found that utilizing a short, reflective self-performance evaluation at the end of each day helps me to identify interactions that went well in terms of delivering on engagement and those that could go better next time. Evolving as an educator helps me to feel more effective and get more enjoyment and fulfillment out of my patient interactions.

It can take a person a long time to change habits and adopt new behaviors. This applies to both patients AND to healthcare professionals. Be patient as you attempt to integrate new frameworks and new approaches to patient engagement. The important thing is to continue to evolve and not get stuck in the "old ways" of doing things simply because they are familiar—like giving a didactic presentation or using overly-prescriptive guidelines that make the daily routine almost impossible to follow.

What methods do you use to foster your own growth and development as an educator? What's one thing you have recently changed in your approach to providing DSME/S?


References:

  1. Li R, Shrestha SS, Lipman R, Burrows NR, Kolb LE, Rutledge S. Diabetes self-management education and training among privately insured persons with newly diagnosed diabetes United States, 2011-2012. MMWR Morb Mortal Wkly Rep 2014;63:1045–1049

Comments


Add a Comment





Allowed tags: <b><i><br>Add a new comment: