TMF’s Strategy of Fun, Class Participation Instills Diabetes Self-management In Patients
The staff at a Harlingen, Texas medical clinic dedicates every Friday afternoon for saving lives by having fun. They engage patients using skits, memorable giant feet and body parts fastened on a large cloth doll with Velcro to teach the use of diabetes self-management and monitoring tools as well as the impact unhealthy eating habits and lack of exercise have on the body’s vital organs.
The staff uses the methods of the Diabetes Empowerment Education Program (DEEP), a licensed diabetes self-management education (DSME) curriculum developed by the University of Illinois, Chicago. The DEEP methods were taught to the clinic staff by TMF Health Quality Institute as the Quality Innovation Network Quality Improvement Organization (QIN-QIO) under contract with the Centers for Medicare & Medicaid Services (CMS).
“We had so much fun attending the (DEEP) classes ourselves that we couldn’t wait to share it with our patients,” said Michele Cash, a physician assistant at the clinic. “The 12 hours of group education, usually over a six-week period, that is provided through the program allows for camaraderie between educators and participants that cannot be matched during an office visit or over the phone. Also, the simple and effective tactile models used in the program ensure that we do not teach over the heads of our patients.”
Ms. Cash said the clinic has been promoting excellent diabetes education for a long time through counseling, handouts and referrals to a diabetes educator, a nutritionist or a dietician. However, she said the DSME curriculum offers much more, specifically time with patients.
“Frequent reinforcement and encouragement is key to improving diabetic health outcomes,” she said. “Our office has now initiated a diabetic coordination-of-care program to increase the frequency of office visits and reinforce diabetic education for those patients whose diabetes is not well controlled. This program is based on the same principles contained in the (DSME curriculum) and it is working. It is improving our patients’ A1c levels and their comorbid conditions, preventing diabetic complications and ultimately improving our patients’ lives.
“We had one participant whose blood sugar was out of control prior to the class, with an A1c of 10.9 percent. His most recent A1c was 7.6 percent, thanks to what he learned in the class, persistent doctor’s office visits and medication adjustments.” (The A1c is a blood test showing a person’s average levels of blood glucose, also called blood sugar, over the past three months. The normal level is below 5.7 percent. A patient with diabetes generally has a reading of 6.5 percent or above.)
Ms. Cash said the clinic chose to conduct the DSME classes on Friday afternoons because the patients who would attend the classes were retired or disabled and were more likely to come to a class held during the day. Although time is precious in a medical clinic, they put aside their normal afternoon’s work because their diabetes patients’ health was even more precious, she said. She said the diabetes education team consisted of her supervising physician, another physician assistant and two medical assistants.
She said they were enthusiastic about empowering their patients with the knowledge and confidence to make important decisions about managing their diabetes. The two physician assistants conducted the classes while the medical assistants participated in the skits and encouraged participation in the learning activities.
“The participants were engaged and responsive,” Ms. Cash said. “It is an exciting and enjoyable way of teaching a very complicated disease in a simple way.”