Using Educators to Their Full Potential and Other Staffing Issues Carole' Mensing, RN, MA, CDE Elaine Sullivan, MS, RN, CDE Rich Jackson, MD

2 Confidential Roles: The Reality  Educator  Clinician  Coordinator  Consultant  Case Management

3 Confidential Roles Defined:  Educator- learning process  Clinician  Coordinator  Consultant  Case Management

4 Confidential Skill Sets: (Mensing, Norris; DS, vol 16, no 2, 2003)  Preparation- Topics, materials, AV’s  Delivery options- demo, visits, discuss  Assessment- individualized, readiness  Documentation

5 Confidential Roles Defined:  Educator- learning process  Clinician- practice standards/ care trends  Coordinator  Consultant  Case Management

6 Confidential Standards  National Standards for Diabetes Self-Management Education (Funnell et all; DC, January, 2007)  Joslin Guidelines, Policy and Procedures  Standards of Medical Care in Diabetes (ADA, DC, January, 2009)  Scope of Practice for Diabetes Educators; Standards of Practice for Diabetes Educators; Position Statements (AADE 2009 )  IDF Standards and Guidelines (2008-9)  State by State Regulations

7 Confidential Roles Defined:  Educator- learning process  Clinician- practice standards/ care trends  Coordinator- program management  Consultant  Case Management

8 Confidential Implementation Stage  Goals / Objectives/ Topics for programs  Methods  Outcomes- satisfaction, etc.  CQI, NCQA  ERP/ DEAP applications and extensions  Scheduling

9 Confidential Roles Defined:  Educator- learning process  Clinician- practice standards/ care trends  Coordinator- program management  Consultant- community advocate  Case Management

10 Confidential Delivery systems/ sites:  Worksites and organizations  Schools, Churches, Community Centers  SNF’s  Media- printed, personalized, mass media, Radio- TV spots  Group Homes  Insurers  Government- policy, local Health Departments  Grants  Other….

11 Confidential Roles Defined:  Educator- learning process  Clinician- practice standards/ care trends  Coordinator- program management  Consultant- community advocate  Case Management

12 Confidential Case/Care Strategies:  Risk Stratification  Monitoring and adjusting care plans  Prioritizing – clinical status and readiness for change  Intensifying care

13 Confidential  So…… what educator roles are billable/ reimburseable???

14 Confidential How do you want your educators to spend their time? RoleBillable Yes or No? Expected Time Actual Time Educator Clinician Coordinator Consultant Case manager

15 Confidential Results of Education Coordinator Time Studies CategorySpring 2009 Fall 2009 Your Expectation Billable time 32%31% Non-billable patient time 22%21% Budget/ scheduling 5%3% CQI 6%3% Staff training 3%4% Marketing 4%6%

16 Confidential Results of Education Coordinator Time Studies CategorySpring 2009 Fall 2009 Your Expectation Curriculum 3%5% Meetings 9%7% Clerical 8%11% Other 7%8%

17 Confidential Very little change since Spring 2009  Are you surprised by your site’s results?  Did anything in your coordinator’s role change after the Education Summit?  If your site is an outlier:  Is there an explanation?  What can you do?  Should we plan an educator time study in 2010?

18 Confidential Are we using staff to their full potential?