Summary
The Specialist Diabetes Team (St Helens & Knowsley) worked with local people to develop a suite of structured education programmes. Diabetes Education through Adult Learning (DEAL) addresses the needs of all people with diabetes – not just selected groups – and it has been incorporated into routine care with no additional resources.
DEAL has transformed the way diabetes education is delivered and is associated with improved outcomes (particularly quality of life and anxiety) and extremely high rates of patient satisfaction. Patients have been heavily involved in the project and this is a key factor in its success.
Results
DEAL transformed the way diabetes education is delivered and has vastly improved patient experience and quality of life.
In one evaluation Quality of life, anxiety, depression, emotional distress, self-management and satisfaction was evaluated in 47 people with Type 2 diabetes using validated tools. Satisfaction with the programme was extremely high.
Compared with baseline, anxiety and depression fell; quality of life improved in all domains and diabetes self care improved. Exploratory interviews were conducted and reinforced the findings from the questionnaires.
The project enabled local service users to become active partners in delivery of diabetes care and to improve their confidence and skills at influencing local diabetes services. The programmes are an integral and key component of the diabetes service and required no additional resources to implement them.
Challenge
Education is the cornerstone of effective diabetes self-management. The DH, Diabetes UK and NDST published guidance (2005) on structured patient education setting rigorous standards that people with diabetes should have access to high quality education.
There was a need to establish education programmes that met the standards, were appropriate to meet the diverse needs of local people and were flexible.
Education needed to embrace the needs of people ranging from the elderly to the young, it had to provide for those with diet-treated Type 2 diabetes and for those with Type 1 diabetes desiring intensive insulin regimens. It needed to be flexible to deal with newly diagnosed and those requiring an ‘educational’ top up.
Furthermore, the challenge was to incorporate education into current routine care to ensure its long run sustainability and success.
Solution
The team developed DEAL, an adult learning tool comprising seven different programmes of structured education designed to meet the national standards and the needs of the local population.
DEAL is learner centred, empowering patients to manage their diabetes by giving them the confidence and skills to do so. Each programme has a structured curriculum, clearly defined and agreed learning outcomes, underpinned by a philosophy of support for self-management. It is theory-driven, evidence-based and utilises a variety of complimentary teaching media and supporting materials.
It is constantly updated to reflect local needs and educators have an expert understanding of diabetes and education theory and undertake ongoing assessment to ensure their competency.
Local people with diabetes were involved in piloting the programmes and continue to be involved in ongoing evaluations and amendments. A system of QA has been established and process and outcome measures have been audited.
Client Verdict
“This innovative project has ensured high quality structured education is available to meet the needs of everyone with diabetes and we are particularly proud of the extent of the input of local people and the feed back we have received from those completing one of the programmes.”
Professor Sarah O’Brien
