News & Publications

New Vision for the Specialty Focuses on Achieving the Quadruple Aim

Project Vision

by AADE | Mar 12, 2019

by AADE Board Member Jan Kavookjian, MBA, PhD, FAPhAJanKavookjian-200px

I’ve been studying outcomes of person-centered diabetes education and behavior change for nearly 25 years in academia, and now as a Diabetes Prevention Program (DPP) Lifestyle Coach, I can honestly say there has been no time of greater excitement and anticipation for the specialty of diabetes education/management/support than now!

You’ve probably heard about the new Vision for the specialty: To drive optimal outcomes through the integration of diabetes clinical management, education, prevention and support. There are also six guiding principles or pillars proposed to facilitate achieving the new Vision. 

I’d like to share some of my recent reflections about one of these six pillars, optimization of diabetes care delivery for the Quadruple Aim.

The Quadruple Aim has been a prevailing strategic objective across US healthcare delivery among systems, care settings and practitioners. In case you’re not specifically familiar with it, the Quadruple Aim strives to positively impact

  1. population health
  2. quality of the patient’s care experience
  3. costs associated with care
  4. meaningfulness of the provider’s experiences.

The fourth aim, recently added to the former Triple Aim, emphasizes the need for providers to experience a positive, thriving work life, which is important to achieving the other three aims. Diabetes educators are very well-positioned to contribute to each component within the Quadruple Aim!

Our specialty addresses each of these aims in several intertwined ways that align very well with our vision of integrating diabetes clinical management, education, prevention and support.

The first aim, improvement of population health, is clearly enhanced by expertly guided diabetes clinical management and education for populations of persons with or at risk for diabetes.


The CDC’s DPP curriculum is disseminated from the evidence-base and forges the role of those practicing within our specialty into the future by improving population health through prevention.


In my own experiences with the DPP program affiliated with our regional hospital’s accredited DSMES program, it has brought a deep sense of meaning to see people with prediabetes not only receive the self-management training needed for prevention of type 2 diabetes, but  also experience an empowering and positive sense of community and support with the others in the classes. The CDC’s DPP curriculum is disseminated from the evidence-base and forges the role of those practicing within our specialty into the future by improving population health through prevention.

In addition, diabetes educators are also able to positively impact population health by carefully monitoring utilization and outcomes data to identify those at highest risk for poor outcomes and provide person-centered care to intervene and reduce those risks.

Impacting the health and well-being of individuals and populations through strategic placement of these evidence-based strategies is rewarding and also enhances the fourth aim, which addresses meaningfulness of practitioner work life. These improved outcomes also ripple out to generate fourth aim benefit for our collaborators — the other care team practitioners who may feel improved work life satisfaction from the improved health outcomes affected and supported by the role of practitioners within our specialty.

In thinking about the second aim, practitioners in our specialty are optimally positioned to help individuals feel positively about their care, particularly when they experience a multidisciplinary team integrating person-centered clinical care and self-management objectives. Both of these are key to achieving optimal target outcomes and are encompassed in the role of practitioners within our specialty.

A major objective of the new Vision is to communicate and gain recognition for the value — the outcomes-impacting, reimbursable value — of the comprehensive and integrated care that is inherent in the professional endeavors of practitioners within our specialty.


Diabetes educators are already providing clinical management, education, prevention and support in ways that should be recognized and conveyed through the guiding messages in the new Vision.


It is essential to address the full complement of possibilities in care for individuals to help them feel empowered to drive their own destiny in the daily operations of their own lives; diabetes educators are already providing clinical management, education, prevention and support in ways that should be recognized and conveyed through the guiding messages in the new Vision.

The last aim strives for positive impact on costs. We can think of this as cost-effectiveness or efficient utilization of healthcare resources, among others. The contributions of diabetes educator expertise compliment other collaborators on the care team and aim to support the patient and other providers in ways that create efficiency that may or may not be immediately quantified. For example, in addition to directly impacting short-term cost and utilization outcomes, cost savings from diabetes educator impact may be indirect or longer-term and include factors like the time saved for other practitioners or long-term risk reduction/cost reduction from helping persons with diabetes or prediabetes engage in self-management to prevent potential complications and/or cardio-metabolic conditions.

I hope you are as energized as I am about what comes next as diabetes educators practicing within our specialty become more recognized for the valuable contributions made to achieving the Quadruple Aim for all!

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