The American Diabetes Association Standards of Care for Diabetes (DM) suggest a survival skills approach to hospital DM self-management education (DSME). Despite evidence that DSME improves diabetes related behavioral and clinical outcomes, fewer than 40-50% of patients in the United States with DM ever receive DSME, and less than 7% within the first year of diagnosis. Furthermore, variable delivery and patient comprehension of DSME and incomplete instruction about how to take DM medications have been described as gaps in the hospital discharge process. Strategies for inpatient delivery of DSME and enhanced discharge support for patients with DM have yet to be delineated. To address these deficiencies, we have developed Diabetes To Go an innovative learner-centered, technology assisted program. Early pilot work suggests that Diabetes To Go improves patient knowledge, enhances medication adherence and leads to reduced hospitalizations and emergency department visits. The long-term goal for the Diabetes To Go program is to create scalable and sustainable solutions for DSME and for DM-related discharge support. The next step in this evolution is to determine the feasibility of integrating Diabetes To Go into hospital nursing unit processes for patient education and discharge planning. Thus, the objectives of the present proposal are two-fold: First, to refine the Diabetes To Go program content based on user feedback and experience; and Second, to design and develop workflow processes to enhance the feasibility of integrating the Diabetes To Go program into nursing unit workflow for patient education and discharge support. Building on our current program, we will use a mixed-methods approach leveraging implementation science frameworks and human factors principles to make individualized DM survival skills education and discharge support more accessible, interactive and engaging for patients to achieve the following specific aims- Aim 1: To refine and optimize the Diabetes To Go program content and implementation processes.
Aim 2 : To conduct iterative rapid-cycle usability testing of the enhanced Diabetes To Go program content and processes and establish a Diabetes To Go program toolkit for widespread implementation. Our transdisciplinary team brings together expertise in diabetes education and treatment, nursing workflow, mobile and e-health technologies, and implementation and delivery science to achieve the study aims. The project aims to support NIDDK's mission through the development, pilot testing, and dissemination of Diabetes To Go, an innovative program to educate and engage patients in diabetes care.
Diabetes survival skills self-management education (DSME) is recommended as a critical component diabetes care to enable optimal health outcomes. Here we propose to refine and test a scaleable and sustainable solution for learner-centered, individualized DSME for in-patients with diabetes. By leveraging e-Health technologies, this model has the potential to cause a paradigm shift in sustainable and generalizable approaches for delivery of patient-centered education, enhance medication adherence, and to support discharge transition to outpatient care.
| Smith, Kelly M; Baker, Kelley M; Bardsley, Joan K et al. (2018) Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams. J Nurs Care Qual : |
| Magee, Michelle; Bardsley, Joan K; Wallia, Amisha et al. (2017) Transitioning the Adult with Type 2 Diabetes From the Acute to Chronic Care Setting: Strategies to Support Pragmatic Implementation Success. Curr Diab Rep 17:6 |
