Association of Diabetes Care & Education Specialists

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How to make the most out of group education classes

May 26, 2015

For my first post, I decided to write about a familiar subject to me and to a number of diabetes educators--group education classes.

Currently, I’m enrolled in a Doctorate in Nursing Practice program at the University of Texas Health Science Center at Houston.  As part of the graduation requirements, I needed to implement a performance improvement project. I was interested in implementing DSME in the primary care setting but faced the challenges of making the program financially viable and sustainable.

Unfortunately, I don’t have much success convincing patients to attend DSME classes at the local outpatient diabetes program and the ones who do attend usually do not want to return for various reasons. Last August, I attended the Johnson & Johnson Diabetes Institute where I learned about the role of Shared Medical Appointments (SMA) in providing diabetes education. SMAs are also known as group medical appointments or group visits. I conducted a review of the literature to learn how other programs have been successful in implementing SMA. I was surprised to find several individuals had been successfully conducting SMAs to manage many chronic conditions.

So, for my project, I decided to implement 90 minute SMAs as a way to provide patients with DSME while improving process and measure outcomes. Billing for the services was an issue. However, we were able to justify the level of services provided by meeting the necessary billing elements. The experience was wonderful but exhausting. The endeavor had a positive impact on patient self-efficacy, outcomes, and patient and provider satisfaction.

A team approach was crucial in making the program succeed. Buy-in from the clinic staff was needed to make group education successful. Identification of an advocate who will ensure the classes are scheduled was important. Through trial and error, we discovered 8-12 patients attending a SMA was an appropriate number to ensure proper education and reimbursement. It was so rewarding to see patients return for a second or third class. We did so well with the project that we are now in the beginning process of applying for Physician Recognition through the National Committee for Quality Assurance.

Do you have experience with SMAs? What do you enjoy or find challenging about implementing group sessions? I highly encourage you to share your stories in providing DSME to a group of patients.

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