CQI Toolkit - DiabetesPro

CQI ToolkitIn this toolkit you will find an explanation of what is required by ADA to meetStandard 10’s criteria of the National Standards for Diabetes Self-Managementand Support. You will also find a user friendly sample worksheets, templates, andexamples.Contents:I.II.III.IV.V.VI.VII.Standard 10CQI and Standard 10 CycleCQI WorksheetCQI Example – A1CCQI Example – ExerciseCQI Example – LDLCQI – Other Sample PlansCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.

CQI ToolkitStandard #10: Quality improvementThe provider(s) of DSME will measure the effectiveness of the education and support and look for waysto improve any identified gaps in services or service quality using a systematic review of process andoutcome data.Review CriteriaA. The DSME program has aquality improvement processand plan in place forevaluating the educationprocess and programoutcomes.B. Quality improvement is basedon regular aggregation ofprogram outcomes data andapplication of results toenhance quality of the DSMEand address gaps in service.Standard Met?Indicators1. There is evidence of aggregation of atleast one participant behavioral goal andone other participant outcome.2. There is documentation of a CQIplan/process (e. g. written policy, annualprogram plan, CQI meeting minutes)based on at least one behavioral goal orother participant outcome.1. There is evidence of aggregate data andsummary for use or application forimprovement of DSME/S(e. g. description of project, summary ofaggregate data, written plan forimprovement, using data),YesTopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.NoYesNoN/A

CQI ToolkitStandard 10 CycleAggregated OtherParticipant OutcomeAggregatedBehavioral Goal(at least one)(at least one)Select at least one ofthe above for.CQI ProjectWhat are you trying to improve, fix or AmendmentsReview Outcomeversus TargetReport Cycleas long as youcontinue to work onthis CQI projectAmend CurrentOperationsReview CurrentOperationsTopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.

CQI ToolkitCQI Project WorksheetA.B.C.D.E.Program’s one or more aggregate patient selected behavioral goal outcome Behavioral Goal Category: Add more lines if neededProgram’s one or more aggregated other participant outcome Other Participant Outcome: Add more lines if needed.CQI Project Enter in line below the one aggregated outcome from A or B above to create your CQI project to address List below what your CQI project will be trying to improve fix or accomplish? What is the CQI project target % outcome you are trying to achieve? %Determine the CQI project outcomes reporting and review cycle: monthly, quarterly, bi-annually.a. Reporting and outcome review cycle will be .CQI CycleF.G.H.I.J.Aggregate outcomesReview outcomes versus targetReview current operations as they relate to the CQI projectAmend current operations to improve CQI outcomesImplement improvementsRepeat cycle starting with F.E) ReportingReview DateD) CQI TargetF) CQI OutcomeG) ReviewOutcomesH) Review currentoperations andconsideramendmentsEnter Date to Report/Review%%Enter Date to Report/Review%%Enter Date toReport/Review%%I)List amendmentsto currentoperationsJ) Date changeImplementedTopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.Enter Date toReport/Review%%

CQI ToolkitSample CQI Project Worksheet – A1CA.B.C.D.E.Program’s one or more aggregate patient selected behavioral goal outcome Behavioral Goal Category: Physical ActivityProgram’s one or more aggregated other participant outcome Other Participant Outcome: A1CCQI Project Enter in line below the one aggregated outcome from A or B above to create your CQI project to address A1C List below what your CQI project will be trying to improve fix or accomplish? Increase the number of participants with an a1c less than 7%What is the CQI project target % outcome you are trying to achieve? 85%Determine the CQI project outcomes reporting and review cycle: monthly, quarterly, bi-annually. Reporting and outcome review cycle will be bi-annually.CQI CycleF.G.H.I.J.Aggregate outcomesReview outcomes versus targetReview current operations as they relate to the CQI projectAmend current operations to improve CQI outcomesImplement improvementsRepeat cycle starting with F.E) ReportingReview DateD) CQI TargetF) CQIOutcomeG) ReviewOutcomesH) Reviewcurrentoperations andconsideramendmentsI)Listamendmentsto currentoperationsJ) Change dateJune 20Enter Date toReport/Review85%December 20Enter Date toReport/Review85%June 20Enter Date to Report/Review85%December 20Enter Date toReport/Review85%%57 %64%79%93 of the 163 participantshad a post DSME A1C lessthan 7%How often you shouldhave your A1C tested isreviewed during class 4 ofthe 5 class series.119 of the 186 participantshad a post DSME A1C lessthan 7%Participants likedunderstanding how theblood sugar level is relatedto A1CAdd to the content of theslide deck discussionabout what A1C is andaverage blood sugar levelrelated to the various %.June 4 15, 20Add content to class 4discussing the % reductionin DM complications witheach % reduction of A1C219 of the 277 participantshad a post DSME A1C lessthan 7%Participants communicatedthat they felt empoweredwith the ability to prevent DMcomplications once theylearned that A1C reduction isdirectly related tocomplication reduction.Create A1C patient trackerscale with BG average.Patient will be able to tracktheir bg as well how it relatesto their daily readingsJun 12, 20December 2, 20TopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.

CQI ToolkitSample CQI Project Worksheet – Physical ActivityA.B.C.D.E.Program’s one or more aggregate patient selected behavioral goal outcomea. Behavioral Goal Category: Physical ActivityProgram’s one or more aggregated other participant outcome Other Participant Outcome: Hospital Admissions due to diabetesCQI Project Enter in line below the one aggregated outcome from A or B above to create your CQI project to address Physical Activity List below what your CQI project will be trying to improve fix or accomplish? Increase the goal achievement rate of the DSME participant’s that select a physical activity goalWhat is the CQI project target % outcome you are trying to achieve? 85%Determine the CQI project outcomes reporting and review cycle: monthly, quarterly, bi-annually.a. Reporting and outcome review cycle will be quarterly.CQI CycleF.G.H.I.J.Aggregate outcomesReview outcomes versus targetReview current operations as they relate to the CQI projectAmend current operations to improve CQI outcomesImplement improvementsRepeat cycle starting with F.E) Reporting ReviewDateMarch 20Enter Date to Report/Review85%40%8 of the 20 participants thatselected a physical activitygoal met their goal.June 20Enter Date to Report/Review85%48%25 of the 52 participants thatselected a physical activitygoal met their goal.September 20Enter Date to Report/Review85%75%36 of the 48 participants that selecteda PT goal met their goal.H) Review currentoperations andconsideramendmentsCurrently the benefits ofphysical activity is discussedduring class 2 of the 4 classseriesAmendments noted in Marchhave resulted in improvedoutcomes but moreimprovements neededI)List amendmentsto currentoperationsAdd physical activityhandouts to class 2 thatrecommend various activitiesand how many calories a150#, 200# and 250# womanor man burn per 60 minutesof the activityDuring the 2nd class showparticipants how to do onestanding in place and onechair exercise for 5 minutes.Ask them if they could do thisduring commercials or aftereach meal for 10 mins.Participants like June amendments andstated this during class. PT goaloutcome data reflected many said theywere doing the activities discussed inclass during 10 min. after meals orduring commercialsIncorporate 5 minutes of a new chairor new standing in place activity duringeach of the 4 classes and continue toencourage participants do them duringcommercials or after meals.J) Change dateMarch 15, 20June 20, 20D) CQI TargetF) CQI OutcomeG) ReviewOutcomesSeptember 12, 20TopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.December 20Enter Date toReport/Review85%%

CQI ToolkitSample CQI Project Worksheet – LDLA.B.C.D.E.Program’s one or more aggregate patient selected behavioral goal outcome Behavioral Goal Category: Physical ActivityProgram’s one or more aggregated other participant outcome Other Participant Outcome: LDLCQI Project Enter in line below the one aggregated outcome from A or B above to create your CQI project toaddress LDL List below what your CQI project will be trying to improve fix or accomplish? Increase the number of participants with an LDL value less than 100mg/dlWhat is the CQI project target % outcome you are trying to achieve? 95%Determine the CQI project outcomes reporting and review cycle: monthly, quarterly, bi-annually.a. Reporting and outcome review cycle will be quarterlyCQI CycleF.G.H.I.J.Aggregate outcomesReview outcomes versus targetReview current operations as they relate to the CQI projectAmend current operations to improve CQI outcomesImplement improvementsRepeat cycle starting with F.E) ReportingReview DateD) CQI TargetF) CQI OutcomeG) ReviewOutcomesH) Reviewcurrentoperations andconsideramendmentsI)Listamendments tocurrentoperationsJ) Change dateMarch 20Enter Date toReport/Review95%57 %93 of the 163 participantshad a post DSME LDL lessthan 100LDL target is discussedduring the preventingChronic Complicationssection of the curriculum.Add video to classdiscussing LDL to show howit deposits in the vessels.March 3, 20June 20Enter Date to Report/Review95%64%September 20Enter Date to Report/Review95%December 20Enter Date toReport/Review95%79%%119 of the 186 participantshad a post DSME LDL lessthan 100The video spiked DSMEparticipant’s interest andthey are asking moreresources on which foodshelp lower LDL.Create and distribute list offoods high in soluble fiberthat can assist with LDLcholesterol reduction.219 of the 277 participants hada post DSME LDL less than 100June 5, 20September 12, 20Participants are asking aboutplant sterol effects on LDL andfood sourcesCreate a plant stanol andsterol list for program and eachclass encourage participant toinclude either/and a plantsterol food or high soluble fiberfood each dayTopCopyright 2016 by American Diabetes Association All rights reserved.This document or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the American Diabetes Association.