Greater clarity, individualized care central focuses of 2022 ADCES National Standards
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A reduction in paperwork burden and more flexibility regarding the personalization of diabetes self-management and education are among the changes in the 2022 National Standards for Diabetes Self-Management Education and Support.
The 2022 National Standards are the first update jointly published by the Association of Diabetes Care & Education Specialists and the American Diabetes Association since 2017. The revised guideline, which was published in The Science of Diabetes Self-Management and Care, includes a reduction in the number of standards from 10 to six with a focus on improving clarity and reducing administrative burden for diabetes care and education specialists.
“The 2022 Standards have basically learned from the past, paid attention to what’s going on right now and looked to the future,” Sacha Uelmen, RDN, CDCES, director of diabetes education and prevention for ADCES, told Healio. “Most of the core concepts are still there, but the names and numbers have changed. Descriptions have been clarified and repetitive content consolidated based on confusion from applicants and existing programs over the years. The 2017 Standards were excellent, and the 2022 revision builds on years of evidence, research and experience to improve upon what was there.”
Number of Standards reduced
The biggest change to the 2022 Standards is the reduction of the number of standards from 10 to six. The number was reduced after representatives from the ADCES met with the American Diabetes Association and CMS and determined the amount of administrative paperwork involved with meeting the Standards needed to be reduced.
“Much of the excess documentation came from lack of clarity and applicability across care settings that are common for diabetes self-management and education services programs and current electronic medical records unequipped for the unique customization previous standards required,” Uelmen said. “Programs tend to over-document to be sure they are meeting requirements, taking time away from patient care and education. In addition, confusion around data collection and reporting as part of continuous quality improvement have been clarified along with a table with common and validated measures to use as examples.”
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, and measuring and demonstrating outcomes.
More individualized care
A greater focus on person-centered services is another big change in the 2022 Standards. The Standards state that that diabetes care and education specialists need to work in partnership with each person with diabetes to determine how to best care for that person. Information should be gathered on health status, learning level, lifestyle and psychosocial factors.
After the assessment, diabetes care and education specialists can develop a person-centered plan that uses the ADCES7 Self-Care Behaviors as a base. Individual outcomes, including clinical, patient-reported, psychosocial and behavioral outcomes, should be tracked to determine the efficacy of the services provided and whether a treatment plan needs to be changed.
“Diabetes affects every person differently, and when you are there to help them with their everyday life, you have to understand their everyday life and help them learn how to fit all the extra work of diabetes into it, without taking over their life,” Uelmen said. “Personalization equals better outcomes, you not only improve their time in range, HbA1c, diabetes distress, medication taking and other labs; they are making better decisions for their life, in their circumstances, within their capacity and goals. When we listen to our patients, answer their questions and let them lead the conversation and care plan, we achieve the quadruple aim.”
The ADCES is also supporting legislation introduced in 2021 in the U.S. Senate by Democrat Jeanne Shaheen of New Hampshire and Republican Susan Collins of Maine, and in the House of Representatives by Democrat Kim Schrier, MD, of Washington that seeks to improve beneficiary access to the Medicare benefit for diabetes self-management education and support.
Uelmen said the added focus on the individual stems partially from Medicare emphasizing group sessions and reimbursing one-on-one diabetes self-management and education services only under special circumstances.
“It was important to separate what is to be required for reimbursement by Medicare and the current evidence for best practices,” Uelmen said. “Advocacy efforts toward legislation that better aligns the benefit with current evidence are actively being pursued by our organization and many others.”
For more information:
Sacha Uelmen, RDN, CDCES, can be reached at suelmen@adces.org.
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