How to train Diabetes Champions 

Increasing the knowledge of all healthcare professionals involved with diabetes can improve glycaemic outcomes and care transitions. A Diabetes Champion programme was discussed at the American Diabetes Association’s 83rd Scientific Sessions. Lisa Buckingham reports. 

Diabetes education is a key component to positive outcomes for those living with diabetes, but there are not enough diabetes educators to go around and not everyone gets referred to them, said Dr Lucille Hughes, Assistant Vice President of the Diabetes Education and Program Design for Catholic Health, Long Island, New York. It’s therefore critical to develop programmes for the extended care team to be able to develop the skills and knowledge they need to impart information to people living with diabetes. Hence, she said, the Diabetes Champion programme. 

Dr Hughes outlined the programme she created in 2008. It’s a nine-week programme with an hour for each session and around 600 people have completed it so far. Its purpose is to promote and increase knowledge of all licensed care givers in the area of diabetes.

It has eight typical subject areas:

• Pathophysiology of diabetes 
• Medications
• Medical nutrition therapy 
• Blood glucose monitoring 
• Diabetes technology 
• Acute and chronic complications 
• Problem solving and leadership skills
• Patient education

What’s key, she said, is to remember that the topics covered should depend on the participants on the course – for example, if the participants are all inpatient staff, when she talks about acute and chronic complications, she would go over insulin-drip protocols and transition from drips to subcutaneous insulin infusion, but if they were care coordinators, the information on complications would be in the context of the information they need to impart to individuals that are newly discharged. 

All participants receive a portfolio with a welcome letter, a pretest, a learning-needs assessment in which they rate their current knowledge and confidence level in various areas (the same assessment is taken at the end of the programme) and a class schedule. Teaching consists of PowerPoints, handouts and a competency exam. She always includes a graduation and gift pack at the end. 

It’s a voluntary programme and no one is forced to attend. She has found that the people that attend want to do more for the patient, but don’t have the knowledge and confidence to do so.

With regard to lessons learned over the years, Dr Hughes discussed what she has changed such as shifting from it from a programme for nurses (it used to be known as the Diabetes Nurse Champion programme) to one for all disciplines; class sizes need to be fairly small (around 20); you must change the curriculum constantly to make sure it’s current, and tailor it based on the needs assessment of the discipline you’re teaching. She also covered the benefits of teaching online – COVID-19 allowed her to pivot to online delivery and this means reaching a much wider audience. Timing is also key, she said – cultivate respect by always starting on time and ending on time, especially as healthcare professionals may worry about courses that run over.

The outcomes have been impressive – for example, pre-test scores on insulin and its administration average at 40% whereas post-test scores are 100%, so it makes a real difference. 

With regard to sustainability, Dr Hughes offers a full-day ‘Keeping the skills alive’ programme once a year. This keeps participants engaged and current in their knowledge, she said. 

The title of the course is ‘Improve glycaemic outcomes and care transitions’ and what she’s noticed over years of teaching is an uptake of referrals from the participants. They often call with questions – perhaps something they’ve learned in class but don’t have the complete confidence to act on it. During each class, the number of referrals to the outpatient Diabetes Education Program increased by an average of five patients per class. 

Providers are also calling, she said, because the Diabetes Champions are telling them that they exist and they’re getting more referrals from those providers. Hypoglycaemic events have also decreased, as measured by the Society of Hospital Medicine. 

In summary:

• Design the curriculum to meet the needs of the participants.
• Use the data you collect to truly customise the curriculum – for example, she said, if she gets a majority saying they have zero confidence with inulin pumps, she spends more time on that part of the curriculum.
• Use the programme evaluation for future classes.
• The most important lesson she learned was that 100% of participants had either a personal connection to diabetes or a desire to improve their knowledge; advanced degrees did not equate to knowledge regarding diabetes care, management and education.

To learn more, enrol on the EASD e-Learning course ‘Patient education and support’.

Any opinions expressed in this article are the responsibility of the EASD e-Learning Programme Director, Dr Eleanor D Kennedy.