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Listed below are the required areas in the Application for Recognition of Diabetes Self-Management Education Programs (6th Edition, by the American
Diabetes Association). The Diabetes Management System contains an on-line worksheet for the 6th Edition along with detailed support documentation and reporting to back up your application data. Much of the required
information is stored on-line, or automatically calculated, based on your parameters. The System has been upgraded to include Application Revisions and documentation as of April 2005.
The
Worksheet also includes a hot link to connect directly to the ADA Recognition Web Site.
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- Application Information...
Type of Application ID Number Number of Sites Data Collection Period (six months)
- Application Demographics Information
Name and Address of Sponsoring Organization Name of Chief Administrative Officer
- DSME Coordinator Information
-(The Diabetes Management System stores All Staff Information, ie, licensure
data, detailed CEU history, resume, hours, responsibilities, employment
history, educational plans, and academic preparation).
Coordinator Name, Address, Phone Numbers, Email. Written job description of the DMSE Coordinator
Academic Preparation in Program Management Academic and/or experimental preparation in the care of persons with chronic disease.
Oversees the planning, implementation, and evaluation of the DSME entity.
- DSME Oversight/Planning
Goal Achievement of DSME operations Data Analysis of DSME operations Mission Statement of DSME
Organizational Structure of DSME Population served by DSME Resources of DSME personnel Behavioral and other outcome data measurements of DSME participants
Documents to support that the advisory system annually plans DSME operations and services based on findings of the annual review.
- Instructors
-(The Diabetes Management System stores All Staff Information, ie, licensure
data, Detailed CEU history, resume, hours, responsibilities, employment
history, educational plans, and academic preparation).
- Site Information
-(The Diabetes Management System records participant class information
attended, and automatically tallies the content areas covered, time spent
teaching, whether the intervention is comprehensive, initial, or follow up.)
Total number of participants who received comprehensive and/or initial
intervention. Total number of participants who received a Follow Up intervention. Total number of participants.
Average number of hours of comprehensive and/or initial DSME received. Average number of hours of Follow Up DSME the participants received.
- Population Served in this Site During the Above Data Period
-(The Diabetes Management System allows you to track all demographic
information. Our reports allow for multiple filters and group identifier codes
to be used to isolate specific population groups.)
Population by Age Groupings Population by Diabetes type Population by Race/Ethnicity
Population by Special Needs Type of Service Area Site Serves Type of DSME Seeking Recognition
- Curriculum at this Site
-(The Diabetes Management System allows you to customize your classes as
to instructor, materials used, content areas covered, time allowed, and
teaching methods used. Many reports are available including attendance,
curriculum listing, and individual class records.)
Provide written curriculum with measurable learning objectives in the 10
content areas. (The Diabetes Management System provides for pre and
post knowledge testing that can measure learned objectives) Curriculum listing including class title, instructor, and content area covered.
Class lists by class or by individual.
- Education Records from this Site
-(The Diabetes Management System provides detailed recording and reporting
to document the following:)
Individualized initial assessment record including medical, social, and diabetes
history. Individual Education Assessment based on the 10 content areas. An education plan based on an individual's needs including measurable
goals and behavioral changes. Records of educational interventions, dates, contents taught and instructor's names.
Outcomes reports based on progress toward measurable goals, risk factor reduction, and behavioral changes. Collaboration among the DSME team.
- Continuous Quality Improvement (CQI) Process at this Site
-Participant Behavioral Outcomes. The Diabetes Management System can
track the following participant behavioral outcomes:
Nutritional Management Physical Activity Medications Monitoring
Preventing, Detecting, Treating Acute Complications Risk Reduction Psychosocial Adjustment HBA1c, HDL, LDL, Triglycerides, Creatinine, Blood Glucose Complications Eye Exams Patient Satisfaction
Quality of Life Self Foot Exam Weights, BMI Blood Pressure Length of Hospital Stays ER Visits Missed Days at School or Work HEDIS Reporting
- Payment Information
-(The Diabetes Management System can record application payment
information and stores current recognition information in the System.)
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