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“ DRESS” for Battle- How to Survive a DSMES Program Audit

“ DRESS” for Battle- How to Survive a DSMES Program Audit. Stephanie Harriman McGrath, PharmD Executive Manager, Pennsylvania Pharmacists Care Network. Disclosures. The presenter has nothing to disclose relative to the content of this presentation. Objectives.

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“ DRESS” for Battle- How to Survive a DSMES Program Audit

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  1. “DRESS” for Battle- How to Survive a DSMES Program Audit Stephanie Harriman McGrath, PharmD Executive Manager, Pennsylvania Pharmacists Care Network

  2. Disclosures The presenter has nothing to disclose relative to the content of this presentation

  3. Objectives Review the purpose and intent of a DSMES program audit Discuss the process in place for an audit Describe how to prepare requested DSMES materials for an audit

  4. DSMES Program Audits • Who? • DSMES Accredited Programs can be audited by Medicare or AADE (or ADA)* • What? • Programs are randomly selected for audit to ensure compliance with National Standards • Where? • Audits will occur on site (AADE) or “desktop” (Medicare) • When? • Audits occur throughout the entire calendar year • Why? • CMS requires the selection of programs for audit (5% of programs must be audited per year). • If a site refuses, accreditation will be withdrawn.

  5. True or False? TRUE A DSMES program audit is a randomly selected on-site visit from AADE to ensure that the program is compliant with National Standards for DSMES.

  6. DRESS for Success! Diabetes Resources Engage assistance Standards Submit

  7. Diabetes • 30.3 million people in the United States have diabetes • 23.8% are undiagnosed • 25.8% of people 65 years and older have diabetes • Prediabetes affects 84.1 million Americans • Nearly half (48.1%) of adults 65 years and older had prediabetes as of 2015 • Diabetes self-management education and support (DSMES) is a critical element of care for all people with diabetes National Diabetes Statistics Report, 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf Accessed 2 Jan 2018.

  8. Resources Read the 2017 National Standards for DSMES….And then read them again! Read AADE Interpretive Guidance document Use both the AADE Interpretive Guidance document and Auditor Checklist in program development

  9. 2017 National Standards for DSMES

  10. AADE Interpretive Guidance document

  11. Auditor Checklist

  12. Auditor Checklist

  13. Engage Assistance • Pharmacy staff members • Everyone must share the mission • Mentors • Binder review • PPA • Toolkits • Webinars • AADE • DEAP@aadenet.org or call 800.338.3633

  14. 2017 National Standards for DSMES

  15. Standards • Standard 1: Internal Structure • Organization Chart • Mission Statement and Program Goals • Letter of Support • Standard 2: Stakeholder Input • Evidence of a documented process • Standard 3: Evaluation of Population Served • Patient population • Allocation of resources • Action plan for barriers

  16. Standards (cont.) • Standard 4: Quality Coordinator Overseeing DSMES Services • Job description • CV • Proof of CE (NABP CPE Monitor is sufficient) • Standard 5: DSMES Team • Process for referral • Job description, CV, proof of CE for every team member • Paraprofessionals (if applicable)

  17. Standards (cont.) • Standard 6: Curriculum • Evidence-based curriculum that is reviewed at least annually and updated as appropriate • Pathophysiology and treatment options • Healthy Eating • Physical Activity • Medication Usage • Monitoring • Acute and chronic complications • Healthy coping • Problem solving

  18. Standards (cont.) • Standard 7: Individualization (Chart) • Assessment to create education plan • Evidence of ongoing education planning and behavioral goal setting with follow up • Standard 8: Ongoing Support (Chart) • Documentation of ongoing self-management support options • Ie. Weight loss support, physical activity programs, smoking cessation

  19. Standards (cont.) • Standard 9: Participant Progress (Chart) • Evidence of at least one SMART behavioral goal • Documentation of at least once clinical outcome measure • Communication back to referring provider • Standard 10: Quality Improvement • Evidence of a procedure for collecting aggregate data • Documentation of a CQI project

  20. Submit • Quality coordinator will be contacted prior to on-site audit • Prepare Binder using Interpretive Guidance document • Must include at least 5 de-identified charts • Prepare staff • Auditor will meet on site for full business day audit • Programs will be notified of audit results

  21. True or False? TRUE To prepare for a DSMES audit, it is prudent to have a Binder of updates DSMES materials to support the National Standards, which includes a de-identified patient chart.

  22. Time to Audit!

  23. Questions?

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