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Cambridgeshire Diabetes Credentialing Project

Cambridgeshire Diabetes Credentialing Project. Project team: Katy Davenport, Chris Loughlan, David Simmons & Candice Ward With thanks to: Helen Hollern, Gordon Watson, Claire Hodge, Frances ?, Steven Platt, Sarah Caton. Cambridgeshire Diabetes Credentialing Project. Background

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Cambridgeshire Diabetes Credentialing Project

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  1. Cambridgeshire Diabetes Credentialing Project Project team: Katy Davenport, Chris Loughlan, David Simmons & Candice Ward With thanks to: Helen Hollern, Gordon Watson, Claire Hodge, Frances ?, Steven Platt, Sarah Caton

  2. Cambridgeshire Diabetes Credentialing Project Background • Varying standards of diabetes knowledge and practices across the NHS = post code lottery • Impact on patient safety and cost to NHS as a result of diabetes • Estimated that £1,000,000 per hour is spent by the NHS on Diabetes care (NHS institution for innovation and improvement, 2009)

  3. % of registered diabetes patients with ESRD Number of registered diabetes patients in PCT

  4. England National Diabetes Audit 2009-10 Prevalence of End Stage Renal Disease requiring dialysis or transplantation in type 2 diabetes: 2003-4 = 0.26% 2009-10 = 0.56% Urine albumin:creatinine testing = 73% BP control to NICE target = 47.3% “many opportunities are being missed to detect kidney disease early and reduce its progression”

  5. Why is there this variation • Patient factors • Practitioner factors • Service factors • Societal factors

  6. Why is there this variation • Patient factors • Practitioner factors • Service factors • Societal factors

  7. Cambridgeshire Diabetes Credentialing Project Background • Nationally work being undertaken in the area of Diabetes Competencies for HCPs • Nursing : Training, Research and Education for Nurses in Diabetes – UK (TREND-UK ) • Dietetics: An Integrated Career and Competency Framework for Dietitians and Frontline Staff • Diabetes UK • NHS Diabetes-potential to link with NICE standards

  8. Cambridgeshire Diabetes Credentialing Project Competency: • How do we ensure HCP’s have the right skills and knowledge for the patient in front of them • Accreditation, • Credentialing, • Certification

  9. Terminology • A competency framework defines the knowledge, skills, and attributes needed for people within a system/organization • Each individual role will have its own set of competencies needed to perform the job effectively • Accreditation is the process in which competency is shown to exist->certification • Credentialing is the process in which competency is shown to be maintained

  10. Accreditation 2008 PCT Progress Survey • 96% of practice nurses had completed formal training in the care of people with diabetes • 63% Warwick/ Bradford diabetes diploma • 59% Individual training days • 26% ENB928 • 24% Insulin for life/ Merit • Is this enough for accreditation? • If so, for which patients? • Who is a Diabetes Specialist Nurse? • How are skills maintained?

  11. Ongoing education 2008 PCT Progress Survey-Practice Nurses • 53% said that their practice allowed them time for CPD training • Rest-100% had to use their own time • 75% said that their surgery funded their CPD

  12. Federation of European Nurses in Diabetes (FEND) American Diabetes Association American Association of Diabetes Educators American Dietetic Association Diabetes Practice Group Diabetes AssociationsIDF Education Consultative Section Canadian Diabetes Association Japan Certification Board for Diabetes Educators Australian Diabetes Association

  13. Educators reported lack of: • recognition by governments • training • funding for training courses • uniform guidelines • acceptance • critical mass • reimbursement

  14. Standards • International Diabetes Federation • National Standards for Diabetes Self-Management Training • Canadian Diabetes Association • Australian Diabetes Association • Diabetes of the Americas (DOTA)

  15. Certification • National Certification Board of Diabetes Educators • Canadian Diabetes Association • Japanese • Australian Diabetes Association

  16. http://www.trend-uk.org/TREND-UK_Feb%202010.pdf

  17. Competency levels • Unregistered practitioner • Competent nurse • Experienced or proficient nurse • Senior Practitioner or expert nurse • Consultant nurse

  18. Competency topics • Promoting self-care • Nutrition • Urine monitoring • Blood glucose monitoring • Oral therapies • Injectable therapies • Hypoglycaemia • Hyperglycaemia • Intercurrent illness

  19. Competency topics • Managing diabetes in hospital: • General admission • Surgery • Pregnancy • Pre-conception care • Antenatal and postnatal care • Hypertension and coronary heart disease • Neuropathy • Nephropathy • Retinopathy

  20. Why? To set out minimum standards required for healthcare professionals to competently undertake their roles during diabetes healthcare service delivery in order to improve health and wellbeing, prevent mistakes and reduce the occurrence of confusing and conflicting messages "The mind is not a vessel to be filled, but a fire to be ignited." Plutarch Thanks to Trudi Deakin for this slide

  21. Thanks to Trudi Deakin for this slide Why? STRENGTHS • Increases competences • Ensures consistency • Reduces mistakes • Prevents conflicting messages • Identifies areas for CPD • Framework for accreditation and credentialing WEAKNESSESS • Missed competences • Time to complete and action • Supervision with proof of evidence • Individual dissatisfaction with current job role and banding OPPORTUNITIES • Skilled and competent workforce • Career progression • Government backing • New needs-led training courses • Improved evidence-based learning at undergraduate training • Increased profile of nutrition THREATS Competency framework is ignored

  22. Cambridgeshire Diabetes Credentialing Project • Seeks to improve quality in the care provided for people with diabetes. The areas of patient care included are diagnosis, management and treatment. • Aims to provide comprehensive support, structure and recognition to a range of informal clinical problem-based learning opportunities for staff at all levels. • Diabetes UK pilot project for competency framework • Linking into NHS Diabetes and TREND

  23. Cambridgeshire Diabetes Credentialing Project • Staff who successfully complete the on-going learning will achieve a credential in ‘Diabetes Management’ for different topics at different levels of expertise.

  24. http://www.cuhp.org.uk/hiec/education.php

  25. Cambridgeshire Diabetes Credentialing Project Key Performance Indicators (KPIs) • Patient safety • Patient experience • User experience • Delivery of education and training • Value for money/productivity

  26. Cambridgeshire Diabetes Credentialing Project Implementation Plan • Pre –pilot Addenbrookes Hospital; Cambridgeshire Community Services; Practice 1 • Pilot Practice 2 • Phase II 6 GP locations • Roll-out Cambridgeshire+ • Linkage with national activity-disciplines/locations

  27. What is the credentialing programme?

  28. What is the credentialing programme?

  29. Accreditation of Professional Practice

  30. What is the credentialing programme?

  31. Cambridgeshire Diabetes Education Programme PC Clusters NHSC CHIEC DH International Standard Bodies Credential in Patient safety and well-being Cambridgeshire Health Innovation & Education Cluster (CHIEC) Funding and Support Faculty/Institute Quality improvement Patient Focus Patient risk QIPP metrics Clinical Governance University Accreditation Credential Diabetes UK Dept of Health Accredited GP Practices Credentialing Programme Pilot Phase II Regional PAC GP Practices Practice Staff CUH Sp Staff Diabetes Care Network OUTCOMES INPUT

  32. Proposal for development of clinical programmes Professional Development Programmes (Institute of Continuing Education, University of Cambridge) ‘Health Science’ Taught modules in PG Cert and PG Dip Research component at MSt Level Part-Time, Credit Bearing Project MSt PG Diploma 120 credits PG Certificate 60 credits CDCP COPD Pal. Med Urol. M. Health HIEC Themes

  33. Cambridgeshire Diabetes Credentialing Project Potential barriers and challenges to date • Time limitations • Co-ordinator essential • Engagement of primary care and staff • Technology and IT infrastructure • Translating theory (PDSA cycle) into clinical practice

  34. Expecting to open Monday April 2nd 2012 • Recruiting from now-any practices • To join the credentialing programme, email: Chris Loughlin CDCP Project Manager on cloughlan@btinternet.com 0044 (0)797 376 9920

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