The Association of Diabetes Care & Education Specialists (ADCES) and the American Diabetes Association have issued the first update since 2017 to the National Standards (National Standards) for Diabetes Self-Management Education and Support, according to an ADCES statement.
The ADA and ADCES use the criteria in the National Standards in accrediting DSMES services and adherence to the Standards is required for Medicare reimbursement.
Updates to the National Standards that aim to increase access and improve health equity by reducing barriers to this critical service include:
- Number of standards reduced from 10 to 6
- Combining the quality coordinator and DSMES team under one standard to reflect the important role the entire care team provides. Included also are more clearly defined qualifications and requirements for DSMES team members.
- Stronger emphasis on personalizing DSMES and ongoing patient support and follow-up.
- A clear documentation structure for DSMES services that can be implemented in any paper or electronic system and an emphasis on the importance of communication and collaboration across the care team.
- Emphasis on the importance of organizational support for DSMES services.
- Clarity around reporting metrics and outcomes for Continuous Quality Improvement.
The 2022 updates include some of the biggest changes since the 1984 introduction of the National Standards, according to the statement. They call for addressing health equity by improving access to diabetes self-management education and support (DSMES) services; for a renewed focus on increasing and maintaining person-centered care; and for reducing the administrative burden on diabetes care and education specialists.
Standards consolidated, patients come first
Efforts to streamline the 2022 Standards for ease of use were based on confusion voiced over the years by applicants and existing programs, according to ADCES. The biggest change to the new Standards is the reduction of the number of standards from 10 to 6, a decision made based on ADCES meetings with the ADA and the Centers for Medicare and Medicaid Services where it was determined that the amount of time and paperwork required to meet the Standards were excessive, the statement says.
Reduction in administrative tasks will allow “more time and focus on providing person-centered education and care to the person with diabetes,” said Leslie Kolb, RN, BSN, MBA, ADCES chief science, practice, and education officer, in the statement. The need for time to focus on individualized services, to partner closely with a patient to learn how care can best be delivered drove other significant changes to the Standards that prioritize patients’ personal capacity and goals.
Medicare-specific reimbursement is contingent on meeting the National Standards which outline recommendations for process, structure and outcomes related to high-quality DSMES services.
The six sections in the 2022 Standards include:
- Community and organizational support for diabetes self-management education and support services
- Population and service assessment
- Guidelines for the diabetes self-management and education team
- Delivery and design of services
- Implementing person-centered diabetes self-management and education services
- Measuring and demonstrating outcomes
DSMES is essential to equip persons with diabetes and their caregivers with knowledge and skills critical for effective diabetes self-management. DSMES has been developed to help persons with diabetes implement and then sustain the effective behaviors that will support effective disease management throughout their lifetime.
“The National Standards for DSMES provide diabetes care and education specialists with structure to guide their services. Timely revision by our colleagues in diabetes care and education align the standards with current evidence-based practices and utilization trends,” said ADA vice president of Health Care Programs Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES, ADA in the statement.
“These updates reflect research for diabetes education and support, behavioral health, clinic and health care environment, technical, and sustainability of business practice.”
The recommendations apply to DSMES delivered in small, one-clinician practices as well as in large multicenter facilities, care coordination programs; population health programs; and technology-enabled models of care, the statement notes.
The 2022 National Standards Revision Taskforce consisted of 22 diabetes care and education specialists recognized for their expertise in a range of health care professional disciplines — including physicians, nurses, pharmacists, registered dietitians, and persons with diabetes. The group based the National Standards on an extensive and comprehensive body of literature.
The complete Standards have been published in Diabetes Care and in The Science of Diabetes Self-Management and Care.