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Sharing Success Stories: 5 Strategies for Increasing DSMES Referrals

May 14, 2019

by Valerie Spier, MPH, RD, CDEValerie Spier, MPH, RD, CDE

As a CDE and Quality Coordinator at Sutter Health in Sacramento, I was thrilled when my organization joined AMGA’s Together 2 Goal® campaign. This national initiative, of which AADE is a partner in, aims to mobilize providers to collectively improve care for 1 million people with type 2 diabetes by 2021. As part of the campaign, Sutter Health committed to increasing referrals for DSMES —one of the 11 evidence-based care processes (or “campaign planks”) that Together 2 Goal® participants can choose to implement. We are in the third year of this effort and the first two years were spent mostly in organizing our resources and designing reports to measure our results. Last year was our big push and this was rewarded in an overall increase in referrals to our SHIDEN Diabetes Education Program by more than 6% (locations varied).

If you are part of a medical group or health system and would like to increase provider referrals for DSMES, here are five strategies to consider:

  1. Create ownership. Our diabetes educators developed their own campaign, “Four Times to Refer,” based on the DSMES Algorithm of Care for adults with type 2 diabetes. We set a goal of increasing referrals to our SHIDEN Diabetes Education Program by 3%, and held regular meetings to discuss activities, progress and results. By creating and “owning” this campaign, our diabetes educators felt invested in the outcomes and were willing to go the extra mile to see results. Additionally, a few managers linked active participation in this campaign with annual performance reviews, including annual merit raises.
  2. Make it easier to refer. Our team worked to remove the barriers to referring a person to DSME. We created standard electronic and paper referrals that were easier to complete and contained all the pertinent information to be compliant and facilitate a smooth transition of care. We developed and distributed a “cheat sheet” on how to refer; provided education on how to create an order in an EHR; and standardized the process of scanning external referrals. These activities made booking patients easier, increased the likelihood of reimbursement, and improved both patient and physician satisfaction.
  3. Build bridges. Our diabetes educators connected with colleagues to build relationships and encourage referrals. We attended physician meetings, joined team huddles, conducted lunch & learns for RNs, and met with nurse case managers and discharge planners. We also enlisted quality leaders to champion the effort and embedded DSMES services within PCP and endocrinology departments to facilitate “warm hand-offs.” Our team acknowledged and thanked our top-referring doctors to reinforce those positive relationships.
  4. Promote your services. We marketed the SHIDEN Diabetes Education Program through a variety of channels. Our team created brochures and flyers for patients and providers and delivered them in the mail; distributed them at huddles and department meetings; and left them in lobbies and urgent care centers. We welcomed new physicians via email and invited them to tour their nearest SHIDEN Diabetes Center. Our team also published articles in internal publications to increase awareness of our services among relevant audiences like hospital leaders, outpatient quality leaders, and physicians.
  5. Join the Together 2 Goal® campaign. Sutter Health’s participation in the Together 2 Goal® campaign helped make all of these activities and the overarching goal of increasing DSMES referrals an organizational priority. Consider sharing this opportunity with quality leaders in your organization to advance your diabetes improvement efforts.

Together 2 Goal® campaignSutter Health Logo

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