Medication Safety Campaign January 26, 2016 - QIO) …qioprogram.org/sites/default/files/QINNCC_MedSafetyCampaignCall... · Medication Safety Campaign. January 26, ... • Randy Fenninger,

1

Medication Safety Campaign

January 26, 2016

Is patient self-management a key to improved patient outcomes, increased medication adherence and reduced drug events?

2

Housekeeping

• You will need to access your registration confirmation email and registration ID to login to WebEx

• Thank you for joining us in the WebEx Event Center• Teleconference: 1-855-339-4595• Feel free to engage with the speakers at any time via the

Chat feature• Questions and comments during the Facilitated Discussion

portion: *1

3

Welcome

• Welcome! • Call materials will be posted to

www.QIOProgram.org• Chat monitors:

– Rachel Digmann– Karen Ten Cate– Lisa Morrise

Marty Hatlie, JDProject Patient Care

http://www.qioprogram.org/

4

Questions to Run On

• How are you engaging beneficiaries and their families in improvement work?

• What have you learned from them that could be used to improve care?

5

Centers for Medicare & Medicaid Services

Anita Thomas, PharmDMedication Safety Lead

6

Agenda

• Continuing Education Credit Overview• Medication Safety Campaign Overview • Speaker Presentations

• Randy Fenninger, National Blood Clot Alliance• Dr. Jack Ansell, Hofstra-North Shore/LIJ School of Medicine• Joan Bardsley, MedStar Health Research Institute

• Facilitated Discussion• Wrap-up

7

Things to Think About

Will you commit to being… • Present• Active participant• Actionable

Show your commitment by clicking the green “check”!

8

Learning Outcomes

• Describe the patient’s perspective about self-management.

• Explain the process for utilizing and referring patients for anticoagulation self-testing and DSME services.

• Describe patient behaviors associated with self-management, and how self-management can improve medication adherence.

• Identify the when, where and how for DSME/S and anticoagulation POC testing.

9

Who’s in the Room?

What organization do you represent?

• CMS• Home Health Agency• Hospital• Nursing Home / Skilled Nursing Facility• Patient, Family or Caregiver Representative• Pharmacy / Pharmacist• Provider / Practice• QIN-QIO• Other (please specify in the comments field)

10

Now Offering Continuing Education (CE) Credit

• Continuing education credit is available for:– Physicians & Physician Assistants– Registered Nurses & Nurse Practitioners– Dietitians– Pharmacists– Certified Professionals in Healthcare Quality– Certificate of Attendance

11

Method of Participation

• You must participate in the entire activity to receive credit.

• A statement of credit will be available upon completion of an online evaluation/claimed credit form.

• The link to the online evaluation will be provided after completion of the activity.

• If you have questions about this CME/CE activity, please contact AKH Inc. at [email protected].

mailto:[email protected]

12

CE Information

Physicians:This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare, CRW & Associates and Telligen. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.

AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants:NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME.

Pharmacists:AKH Inc., Advancing Knowledge in Healthcare is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.AKH Inc., Advancing Knowledge in Healthcare approves this knowledge-based activity for 1.0 contact hour (0.1 CEU). UAN 0077-9999-16-002-L04-P. Initial Release Date: 1/26/2016

CPHQ:This program has been approved by the National Association for Healthcare Quality for 1.00 CPHQ continuing education hours.

13

CE Information

Registered Nurses:AKH Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.This activity is awarded 1.0 contact hour.

Nurse Practitioners:AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider Number: 030803.This program is accredited for 1.0 contact hour which includes 0 hours of pharmacology. Program ID #21610-1.

This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standard

Dietitians:AKH Inc., Advancing Knowledge in Healthcare is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.0 continuing professional education unit (CPEU) for completion of this program/material. CDR Accredited Provider #AN008. The focus of this activity is rated Level 2. Learners may submit evaluations of program/materials quality to the CDR at www.cdrnet.org.

www.cdrnet.org

14

Disclosure of Financial Relationships & Commercial Support

• Jack E. Ansell, MD, MACP– Stock: Perosphere, Inc– Consultant: Alere Home Monitoring; Boehringer Ingelheim; Bristol Myers Squibb;

Daiichi Sankyo; Instrumentation Laboratories; Janssen; Perosphere; Pfizer; RocheDiagnostics

• Joan Bardsley MBA, RN, CDE, FAADE– Speakers Bureau: Novo Nordisk– Consultant: Eli Lilly

• Planners and faculty that do not have any relevant financial relationships to disclose:– Randolph B. Fenninger, JD– Marty Hatlie, JD– Rachel Digmann, Pharm.D., BCPS– Anita Thomas, Pharm.D– AKH Inc. , CRW & Associates and Telligen

• No commercial support was received for this activity.

15

Disclosure of Financial Relationships & Commercial Support

DisclosuresIt is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Author Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other author for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.

Disclosure of Unlabeled Use and Investigational Product This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.

16

National Medication Safety Campaign

Rachel Digmann, PharmD, BCPSMedication Safety & Program LeadTelligen

17

Scope of the Problem

18

What is the National Medication Safety Campaign?

• It’s a collaborative informed and driven by the experiences ofmedication users successfully managing their medication use.

• The collaborative will develop and pilot test several innovativeself-management methods for safe medication use in a numberof beneficiary/provider communities.

• The tested and proven self-management innovations will bethen spread community by community through a collaborativeeffort with (a) health care provider organizations and (b)community based organizations and ( c) membershiporganizations.

19

What is the National Medication Safety Campaign?

• The collaborative will use campaign tactics to raise awareness,motivate and integrate best practices across national qualityimprovement initiatives.

• Patient advocates, provider networks and already establishedmedication safety programs will be recruited

• Interested QIN-QIOs, and other collaborative communityorganizations, will play a leadership and organizing role inrecruiting and aligning community based coalitions andpartnerships

20

What will the National Medication Safety Campaign do?

• Implement a pilot project to test promising self-management methods; impact a number of medicationusers (patients/families/neighbors)

• Harvest best practices and spread nationwide• Recruit caregivers, providers, community organizations,

QIN-QIO, federal, state and local entities to spread theinnovative methods to Patients and families

• Connect patients, families & caregivers to localmedication safety and effectiveness initiatives

21

National Medication Safety Campaign

A Two Phase Campaign

Phase 1. (12 months)Develop and test

successful patient medication self-management programs by 1/1/17 using rapid cycle prototyping

Phase 2. (18 months)Health coalitions in 50% of counties in US have adopted the evidence-based medication self-management system by 12/18.

National Medication Safety Network formed to

Continue Spread and Improvement of Medication Self-

Management System

Impact: CMS estimates increase in patient at goal, reduce care utilization, reduced

total cost of care.

Outcome: Health coalitions in 50% of counties adopt evidence-based medication self-management system

22

Benefits of Joining the National Medication Safety Campaign

• Engage beneficiaries on an issue extremely important to them and makeuse of their motivation, goodwill and wisdom

• Learn from beneficiaries who are successfully managing medication use• Become a change agent working together with others of like motivation to

impact the safety and quality of medication use for patients nationally• Identify, pilot and spread promising new medication use concepts,

practices and tools that will help your community• Shape new medication safety related Intervention Effectiveness Measures

(IEMs)• Share and gain access to resources and faculty• Protect your family and friends from medication-related harm• Be a leader in your community

23

Call to Action: Join to Learn More!

• Sign-up to learn more about the Campaign:– Visit

https://app.smartsheet.com/b/form?EQBCT=8a441766bd434d2ebbf31bcee214a905

• Invite others who are passionate about safe medicationuse to join the campaign

• Attend upcoming QIN-QIO events for local spread teams• Keep and eye out for more information• QIO Program website (http://QIOProgram.org)


http://qioprogram.org/

24

National Blood Clot Alliance

Randy FenningerChief Executive Officer

VISIT OUR WEBSITE AT www.stoptheclot.org

http://www.stoptheclot.org/

25

Hofstra-North Shore/LIJ School of Medicine

Jack Ansell, MDProfessor of Medicine

26

Enhancing the Management of Warfarin Therapy:

Reducing adverse events and improving patient outcomes

Jack Ansell, MD, MACPJanuary 2016

• Disclosures• Consultant: Alere Home Monitoring, Roche Diagnostics,

Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo,Janssen, Pfizer

27

The goals of this presentation are to . . . .

1. Review the problems with current warfarintherapy;

2. Discuss how warfarin therapy is managed;3. Compare the outcomes when patients monitor

their own therapy at home vs standard care;4. Suggest why such management makes sense.

28

The quality of warfarin management in the US is poor! From: Dlott et al. National Assessment of Warfarin AC Therapy for

Stroke Prevention in AF. Circ 2014:1407

138,319 individuals referred by 37,939 physicians, yielding a total of 2,683,674 INR results. The mean TTR was 53.7% overall and improved with time on treatment, increasing from 47.6% for patients with <6 months of testing to 57.5% for those with ≥6 months of testing (P<0.0001). The number of patients tested per physician practice was positively associated with time in the therapeutic range.

29

Warfarin therapy can be dangerous!

The vitamin K antagonists (VKAs) are responsible for:

1. The most emergency hospitalizations due to an adversedrug event (bleeding)1

2. The most emergency room visits due to an adverse drugevent2

3. The most common cause of death associated with anadverse drug event3

1 Budnitz et al. Emergency hospitalizations for adverse drug events in older Americans. N Eng J Med 2011;365:2002-2012.2 Budnitz et al. Medication use leading to emergency department visits for adverse drug events in older adults. Ann Intern Med 2007;147:755-7653 Shepherd G et al. Adverse drug reaction deaths reported in United States Vital Statistics, 1999-2006. Ann Pharmacotherapy 2012;46:169-175

30

We can do better!Models of Anticoagulation Management

Routine Medical Care (Usual Care)AC managed by physician or office staff w/o any systematic program for education, follow-up, communication, and dose management. May use POC device or laboratory INR

Anticoagulation Clinic (ACC)AC managed by dedicated personnel (MD, RN or pharmacist) with systematic policies in place to manage and dose patients. May use POC device or laboratory INR

Patient Self-Testing (PST)Patient uses POC monitor to measure INR at home. Dose managed by UC or ACC

Patient Self-Management (PSM)Patient uses POC monitor to measure INR at home and manages own AC dose

Campbell PM et al. Dis Manag Clin Outcomes. 2000;2:1-8;.Ansell JE. In: Ansell JE, Oertel LB, Wittkowsky AK, eds. Managing Oral Anticoagulation Therapy. 2nd ed. St. Louis, Mo: Facts and Comparisons; 2003;44:1-6.

31

Challenges With Conventional Laboratory Testing

• Patient issues– Time for traveling to office or laboratory– Ability to travel– Need for venous access

• Labor-intensive and higher costs– Scheduling visits– Proper handling and delivery of sample– Documentation at several time points

• Potential for communication delays– Laboratory to contact provider with results– Provider to contact patient with dosage adjustments

Jacobson AK. In: Ansell JE, Oertel LB, Wittkowsky AK, eds. Managing Oral Anticoagulation Therapy. 2nd ed. St. Louis, Mo: Facts and Comparisons; 2003;45:1-6.

32

Point-of-Care Devices

33

Heneghan Meta-Analysis (2011)(individual patient data)

PSM

PST

PSM

PST

Thrombosis

Major Bleeding

Heneghan et al. Lancet 2012;379:322-334

34

Cochrane Analysis: PST and PSM Outcomes Thromboembolism & Major Bleeding

PSM 53% reduction in TE (significant)PST 43% reduction in TE (not significant)Total 50% reduction in TE (significant)

PSM 12% increase in MB (not significant)PST 44% reduction in MB (significant)Total 13% reduction in MB (not significant)

35

STABLE Study: Real World PST Data

• Retrospective analysis of Alere Home Monitoring companydatabase

• 69,000 patient database performing PST at home• 3.2 million test results• INR tests included from all physician and care settings• Primary outcome: % TTR by Rosendaal method• Study duration: 2.5 years (Jan 2008 – June 30, 2011)• First 3 months of PST data excluded• Study groups included:

Weekly testing group 5-9 days between tests (> 80% adherent)

Variable testing group 10 days - 4 weeks between tests

DeSantis et al. Amer J Managed Care 2014;20:202-209

36

STABLE Study:Retrospective analysis of real-world PST: time in therapeutic range

Characteristic MeanAge

n(%)

Mean TTR % (n)Overall Variable Weekly

Male 70.216,527

(56%) 72.0% 71.1% 76.0

Female 70.613,002

(44%) 66.5% 65.5% 71.2 %

Total study population(Age range 7 mo.–105 yrs) 70.4 28,529 69.6% 68.6% 73.9%

Primary Indication for AC

MHV only 64.75,353 (18.1) 65.9% 64.7% 71.2%

AF, no MHV 73.421,224

(71.9) 70.8% 69.9% 74.5%

AF & MHV 69.31466(4.9) 66.2% 65.0% 71.7%

DVT & PE 70.41,050

(3.6) 67.1% 66.2% 73.6%


37

STABLE Study: Retrospective analysis of real-world PST: weekly vs variable

(p<0 000.1)

73.9%

68.6% critical values = INR < 1.5 or > 5.0


38

STABLE Study: Retrospective analysis of real-world PST: comparable TTR

Study TTR (%)Alere weekly PST (real world) 73.9%

RE-LY Trial (dabigatran) 64%

ROCKET-AF Trial (rivaroxaban) 55%

ARISTOTLE Trial (apixaban) 62%

Heneghan Meta-Analysis (2006) 66%

THINRS Trial (2010) 66.2%

Bloomfield Meta-analysis (2011) 66.1%


39

ACC vs PST Real World Data

• 10,000 MD’s, 5.8M INR’s annually, 500 AC clinicsnationwide & Germany

Data source: Standing Stone software program CoagClinic

• INR data range: Sept 2013 – Sept 2014• INR data included Point of Care and Self-testing only• Each state was evaluated by:

% TTR variance %TTR % Incidence of Critical Value Testing Frequency Gender

40

Regional Performance

41

Why would Home Monitoring achieve better outcomes ?

• Access to testing– Frequency (convenience), timeliness

Greater Time-in-Range

• Consistency of testing– Instrument & thromboplastin

Consistent Results

• Awareness of test results– Knowledge, empowerment, compliance

Greater Time-in-Range

Jacobson AK. In: Ansell JE, Oertel LB, Wittkowsky AK, eds. Managing Oral Anticoagulation Therapy. 2nd ed. St. Louis, Mo: Facts and Comparisons; 2003;45:1-6.

42

Take Home Points . . . .

• Patient self-testing at home with or without self-doseadjustment is an effective and safe means of managingwarfarin therapy.

• Meta-analyses indicate that PST and PSM are more effectiveand just as safe as standard management (mixture of ACCand UC).

• Analysis of a large data base of real world patients performingPST shows that those who test frequently (weekly) have a rateof TTR > 73% and the overall group, a rate of TTR of > 69%.

• Recent ACCP guidelines (2012) recommend PSM (2B).For patients treated with VKAs who are motivated and can demonstrate competency in self-management strategies, including the self-testing equipment, we suggest PSM rather than usual outpatient INR monitoring (2B). For all other patients, therapy should be performed in a systematic and coordinated fashion.

43

Thank you !

44

MedStar Health Research Institute

Joan Bardsley, MBA, RNAssistant Vice President

Patient-Centered Care:The Diabetes Education and Support AlgorithmA JOINT POSITION STATEMENT OF THE AMERICAN DIABETES ASSOCIATION, THE AMERICAN

ASSOCIATION OF DIABETES EDUCATORS, AND THE ACADEMY OF NUTRITION AND DIETETICS

Collaboration

46

Writing Team• Margaret A. Powers (Chair)• Joan Bardsley• Marjorie Cypress• Paulina Duker• Martha M. Funnell• Amy Hess Fischl• Melinda Maryniuk• Linda Siminerio• Eva Vivian

5Powers MA et al. DSME/S Position Statement 201Diabetes Care, The Diabetes Educator, Journal of Academy of Nutrition and Dietetics

Definitions

47

Diabetes Self-management Education (DSME) Ongoing process of facilitating the knowledge, skill, and ability necessary for diabetes self-care

Diabetes Self-management Support (DSMS) Activities that assist in implementing and sustaining the behaviors needed to manage diabetes

Haas L and Maryniuk MD et al. National Standards for DSME/S Diabetes Care; 2012

Purpose of Position Statement

• Address triple aim - Improve patient experience of care and education, improve health of individuals and populations, reduce diabetes-associated per capita health care costs

• Provide health care teams with information required to better understand the educational process and expectations for DSME and DSMS and their integration into routine care

• Create a diabetes education algorithm that defines when, what, and how DSME/S should be provided for adults with type 2 diabetes

48

Powers MA et al. DSME/S Position Statement 2015Diabetes Care, The Diabetes Educator, Journal of Academy of Nutrition and Dietetics

Benefits Associated with DSME/S

• Improved health outcomes – Reduced A1c by as much as .88% – Reduced onset and/or advancement of complications– Reduced hospital admissions and readmissions– Increased medication adherence

• More healthful eating patterns and regular activity• Enhanced self-efficacy and empowerment

– Increased healthy coping– Improved quality of life

NOTE: 1) Benefits of education decrease over time, 2) sustained improvement requires time and follow-up, and 3) effectiveness directly correlated to amount of time spent with educatorPowers MA et al. DSME/S Position Statement 2015Diabetes Care, The Diabetes Educator, Journal of Academy of Nutrition and DieteticsNorris SL, et al. Diabetes Care 2001

8

Evidence ConfirmedAADE: Systematic Review of the Impact of Diabetes Self-Management Education on Glycemic Control in Adults with Type 2 Diabetes

50

AADE. Systematic Review August 2015Pillay et al. Annals of Internal Medicine 2015

PICOS QuestionPICOS component Study question

P Patient population or problem Adults with type 2 diabetes

I Intervention Diabetes Self-Management Education

C Comparison group Usual care

O Outcomes A1C

S Setting Randomized controlled trials

AADE. Systematic Review August 2015

Participants

Intervention Group (SD) Usual Care Controls (SD)

Mean Age 58.5(5.21) 58.7(5.35)Mean Baseline A1C 8.55(1.11) 8.48(1.08)Number Enrolled 11,854 11,093Number at Follow-up A1C 11,584 10,466

52


Change in A1C: Single versus Team DSMEProvider Number of

interventionsIntervention

(SD)Control (SD) Absolute

Difference in A1C with

DSME added

Single 69 -0.74(0.63) -0.17(0.49) 0.57Team 46 -0.74(0.64) -0.18(0.54) 0.56

53

Change in A1C by Mode of DSME Delivery

Mode Number of interventions

Intervention (SD)

Control (SD) Absolute difference in A1C with addition of

DSME

All Models Together

118 -0.74(0.63) -0.17(0.5) 0.57

Combination 22 -1.0(0.6) -0.22(0.62) 0.88

Group 33 -0.62(0.46) -0.10(0.42) 0.52Individual 47 -0.78(0.63) -0.28(0.46) 0.50Remote 12 -0.50(0.67) -0.17(0.46) 0.33

54


Change in A1c Based on DMSE Contact Time

Time Number of interventions

Intervention (SD)

Control (SD) Absolute Difference in

A1C with DSME added

<10 hours 55 -0.71(0.55) -0.25(0.47) 0.46

>10 hours 36 -0.84(0.65) -0.15(0.55) 0.69

55


Summary• Engaging adults with type 2 diabetes in DSME results in

statistically significant and clinically meaningful improvement in A1C

• These data demonstrate that DSME that involves both group and individualized engagement results in the greatest improvement in A1C

• The data suggest that there is a greater likelihood of DSME resulting in statistically significant improvement when a team rather than a single individuals is involved in its provision

• The data suggest that limiting DSME contact time to 10 hours may not be sufficient

56

Barriers to DSME/S• Time• Location• Referral• Diversity• Value confusion• Clear expectations• Cost, reimbursement

DSME/S Algorithm of Care4 Critical Times for DSME/S

59

4 critical times to assess, provide and adjust DSME/S

1. At diagnosis2. Annually3. When complicating

factors occur4. When transitions in care

occur

DSME/S Algorithm of Care


At Diagnosis

• All individuals with type 2• Include emotional health and nutrition

61

AnnuallyAnnual assessment of education, nutrition and emotional health needs• No prior education • Change in medication • HbA1c out of range• Maintain positive health outcomes • Planning pregnancy• Support • Weight issues• New life situations

62

Complicating Factors

When new complicating factors influence self management• Health conditions• Physical conditions• Emotional factors • Basic living needs

63

TransitionsWhen transition in care occur• Living situations• Medical care team • Insurance coverage• Ages related change

64

Areas of Focus: Patient-centered Assessment

Sample questions to guide a patient-centered assessment1.How is diabetes affecting your daily life and that of your family?2.What questions do you have?3.What is the hardest part right now about your diabetes, causing you

the most concern or most worrisome to you about you diabetes?4.How can we best help you?5.What is one thing you are doing or can do to better manage your

diabetes?


Areas of Focus and Action StepsAt Diagnosis

Primary care provider / endocrinologist / clinical care team

•Answer questions and provide emotional support regarding diagnosis

•Provide overview of treatment and treatment goals

•Teach survival skills to address immediate requirements (safe use of medication, hypoglycemia treatment if needed, introduce eating guidelines)

• Identify and discuss resources for education and ongoing support

•Make referral for DSME/S and MNT

Areas of Focus and Action StepsAt Diagnosis

Diabetes Education

Assess cultural influences, health beliefs, current knowledge, physical limitations, family support, financial status, medical history, literacy, numeracy to determine which content to provide and how regarding:

• Medications• Monitoring blood glucose• Physical activity• Acute and chronic complications• Psychosocial issues and concerns• Health and behavior change

67

Areas of Focus and Action StepsAnnually


•Assess all areas of self-management

•Review problem-solving skills• Identify strengths and challenges of living with diabetes

68

Areas of Focus and Action StepsAnnually

Diabetes Education

•Review and reinforce treatment goals and self-management needs

•Emphasize preventing complications and promoting quality of life

•Discuss how to adapt diabetes treatment and self-management to new life situations and competing demands

•Support efforts to sustain initial behavior changes and cope with the ongoing burden of diabetes

69

Areas of Focus and Action Steps Complicating Factors

70


• Identify presence of factors that affect diabetes self-management and attain treatment and behavioral goals

•Discuss effect of complications and successes with treatment and self-management

Areas of Focus and Action Steps Complicating Factors

Diabetes Education

• Provide support for the provision of self-care skills in an effort to delay progression of the disease and prevent new complications

• Provide/refer for emotional support for diabetes-related distress and depression

• Develop and support personal strategies for behavior change and healthy coping

• Develop personal strategies to adapt to sensory or physical limitation(s), adapting to new self-management demands, and promote health and behavior change

71

Areas of Focus and Action StepsTransitions


•Develop diabetes transition plan•Communicate transition plan to new health care team members

•Establish DSME/S regular follow-up care

72

Areas of Focus and Action StepsTransitions

Diabetes education

• Provide support for independent self-management skills and self-efficacy

• Identify level of significant other involvement and facilitate education and support

• Assist with facing challenges affecting usual level of activity, ability to function, health beliefs, and feelings of well-being

• Maximize quality of life and emotional support for the patient (and family members)

• Provide education for others now involved in care• Identify needed adaption in diabetes self-

management• Establish communication and follow-up plans with

the provider, family, and others

DSME/S Algorithm of Care


75

Facilitated Discussion

• Submit questions and comments through the Chat• Press *1 on your telephone key pad to enter the

queue

76

Call to Action: Join to Learn More!

• Sign-up to learn more about the Campaign:– Visit


• Invite others who are passionate about safe medication use to join the campaign

• Attend upcoming QIN-QIO events for local spread teams• Keep and eye out for more information• QIO Program website (http://QIOProgram.org)


http://qioprogram.org/

77

Call For Future Topics

• We want to hear from you!• Do you have a need or desire to hear about a certain

topic during the National Medication Safety Campaign?

• Submit your ideas in chat or email us at [email protected]

mailto:[email protected]

78

Save the Date!

• Join us for the next Medication Safety Campaign Call – Tuesday, April 26, 2016– 3:00-4:00 PM ET– Registration is required! Register at http://qualitynet.webex.com/ Navigate to the Medication Safety Campaign event on April 26,

2016 Click “Register”

http://qualitynet.webex.com/tc

79

Thank you!

This material w as prepared by Telligen, the Quality Innovation Netw ork National Coordinating Center, under contract w ith the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-QINNCC-00611-01/19/16

Documents

Medication Safety Campaign January 26, 2016 - QIO) …qioprogram.org/sites/default/files/QINNCC_MedSafetyCampaignCall... · Medication Safety Campaign. January 26, ... • Randy Fenninger,