LOGIC No 1: March 2017 | Page 17

responsibility through utilizing the expertise of the specialist service and other professional groups to support their work . Clinical isolation is reduced for health practitioners and perhaps burn out risks mitigated to a degree .
The Diabetes Clinical Network meets quarterly to review issues , concerns and analyse clinical data . They report to the ALT , who has the DHB wide mandate through management processes to remove barriers to improve care . They monitor key indicators such as the number of patients who have HbA1c > 64 mmol / mol and need to be on insulin , or how many nurses have completed the New Zealand Society for the Study of Diabetes ( NZSSD ) endorsed Diabetes on line e learning programme . Nationally , CCDHB has the highest uptake of this programme .
The graph below shows a decrease in the referrals to specialist service in the priority practices compared to the other practices
Diabetes workforce development for the DHB is based on prioritizing gaps in service from the 2014 Quality standards for diabetes care toolkit ( MoH ). Last year , workforce development included sessions on psychological support and diabetes distress for patients . Nurses , GPs , consultants and allied health attended the 3 geographically located sessions . Nursing peer support sessions are also held monthly over two sites . Sessions are well attended by up to 12-20 nurses at a time . Case studies an educational topic are discussed .
Effective diabetes change requires relationship building , clear goals , appropriate measures and a focus on the person with diabetes . The introduction of the DCIP has led to a system wide improvement in diabetes care locally . The change process has taken a little longer than anticipated , for example introducing selfmanagement groups and rolling out the work to all practices .
However , a senior diabetes specialist colleague recently said working with an outreach focus to up skill and support GP teams has been “ like a breath of fresh air ”.
In a local survey of PPs , respondents listed “ Access to specialist knowledge ” and “ Upskilling and education ” as the most useful parts of the DCIP model .
The Diabetes Nurse Practice Partnership ( DNPP ) and is a key component of the DCIP . It was formally introduced in 2016 and is another topic for another time . The vision agreed for the DNPP team was “ Quality Diabetes care for all , irrespective of race or where you were seen in the DHB ”.
References
American Diabetes Association ( 2017 ). Standards of Medical Care in Diabetes -2017 . American Diabetes Association . Retrieved from
http :// professional . diabetes . or g / sites / professional . diabetes . or g / files / media / dc _ 40 _ s1 _ final . p df
Capital and Coast District Health Board Integrated Care Collaborative . ( 2012 ). CCDHB Diabetes Care improvement Plan . September V4 . Wellington : Author .
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