Building Patient-Centered Systems of Care: Innovation in DSMES Programs, Part 3

Abstract

Spotlight on Janelle Couture, MA, RDN, CD Janelle Couture, MA, RDN, CD, is the Health and Nutrition Education Specialist at Aging & In-Home Services of Northeast Indiana, Inc. When the area agency decided to develop a diabetes education program, they turned to Couture to help get it off the ground When she and her colleagues were developing the DSMES program, they made an effort to gather patient preferences and feedback while they were still in the beginning stages. Couture says, “With funding from the Older Americans Act, our agency provides no-cost lunches at various sites throughout our 9-county area. Part of my job is to provide nutrition and wellness education talks at these sites. When the Agency decided to create a more formalized diabetes education practice for older adults, they asked me to help develop the program. Our patient population is 60 and over, and they have very particular needs. I knew that a standard program would not effectively serve our patients.” Couture continues, “Prior to development, we met with a consultant and she suggested that we start with a patient needs assessment to determine the best program design for our target population. We developed a survey and sent it out to case managers and patients so that we got a clear understanding of how to best serve them. “Part of our agency’s services is to connect with older individuals and provide them with support and care to help them stay in their homes,” says Couture. “We work with case managers who are continually in contact with their clients. So, we had them conduct the surveys over the course of a month. I also did surveys during my nutrition talks. This was a great source of information, and we used the findings to help design the program.” The survey gathered information about the individual’s preferences on how to receive care— the delivery method and timing of sessions—and their priorities and concerns. Couture explains, “The survey helped us have a better understanding of our older patients. What were they interested in? How much did they know about diabetes selfmanagement? What days of the week were best for receiving care? We found that 40% had never taken diabetes education and of those who had, they had education well over 5 years ago. Approximately 45% said they were interested in receiving diabetes education. Their feedback made it clear Individualization and patient-centered care are featured prominently in the recent versions of the National Standards for Diabetes Self-Management Education and Support (National Standards). So what does that mean for educators who are designing a new DSMES system or updating the services they currently offer? This is Part 3 of a 5-part series, “Innovation in DSMES,” focusing on patient-centered strategies to help educators improve the design and delivery of diabetes care.