Like us, you may wonder what qualifies a CDE to win the national award for Diabetes Educator of the Year?
Joanne Rinker was recently named Diabetes Educator of the Year for 2013 (they’re picked in advance of the coming year). She’s a North Carolina-based dietician-educator who’s helped build a unique program for spreading diabetes education across her state. She also focuses on the relationship between diabetes and hearing loss, AND she works as a coach for the patient-led mentoring and exercise program Fit4D.
To hear Joanne tell it, she was pretty surprised to win the award herself. She joins us today to share her personal story and talk about the education model she’d like to see spread across the country:
A Guest Post by Joanne Rinker
When I graduated from college at West Virginia University, my first job was working in an out-patient diabetes self-management program in Pinehurst, NC. The crazy thing is that I had no idea if I was going to like diabetes education, but after just a few short weeks, I realized it was exactly what I wanted to do. I spent the next two years getting enough hours to be able to sit for my CDE exam.
The reason I loved out-patient diabetes education was because I could actually continue a relationship with a patient from the initial assessment, education classes and through follow-ups. So I got to see a patient progress. I got to see them improve A1c, lower blood pressure and cholesterol and improve their quality of life. I have had patients who came into diabetes education classes with no energy, unable to exercise, poor eating habits and not following their medication regimen. Through diabetes education, we worked together to set goals, work on medication reminders so that meds are taken as prescribed, set small exercise goals and work on eating behaviors one at a time. In the end, they have been able to move more, improve blood pressure, A1c, develop healthier eating habits and even get a job! This is why I love diabetes education!
What I love most about my current job as program coordinator of the North Carolina Diabetes Education Recognition Program (NC DERP) is the ability to work with diabetes educators across my state to increase access to diabetes care for those patients who otherwise would not have access. I love the ability to help them work through treatment plans for challenging patients and work with them to improve their diabetes education programs to encourage behavior change for all patients.
Our biggest challenge is the fact that NC is a huge state. It takes about 9 hours to get from one end to the other. That means it can be very challenging to maintain ongoing relationships with all 100 educators who work with the DERP. I am so grateful for technology, conference calls, webinars and annual meetings where we all get to come together and share experiences, tips and resources.
2012 has certainly been a big year for my career! I have been working on program improvement for the NC DERP, which is unique in that the state holds the administrative burden of an American Diabetes Association (ADA) recognized program, while the individual health departments in various counties get to focus on education. This allows the state to fund application fees, provide educational resources, curriculum, educator trainings and CEUs (continuing education units), etc., for health departments that choose to be part of this program.
When I helped start the NC DERP in 2007, we had only 5 health department sites; now there are diabetes self-management programs available in 40 local health departments in 50 counties and a total of 58 service delivery sites. This makes the program the largest ADA-recognized group of sites/locations to access diabetes self-management education (DSME) in the US. This year, we are working hard to help increase the ability to bill for all patients who are served at all of our 58 sites. All billing staff at each location has been trained and currently are in different phases of being able to bill the multiple insurance companies. We have also worked with each of the sites to determine what works to help increase referrals to the DSME programs and then keep the patients engaged so that they will complete the program.
Since we are the only state in the U.S. that has a DSME program set up this way, it makes us very unique. This program is largely successful because there is a desire to do the program by both the local health director and the educator(s) who are chosen or who step up to be a part of the program locally.
The goal of the NC DERP is to increase access to care and decrease risk of diabetes-related complications through blood sugar control. There are over 100 educators who work within this program. I am so lucky to be able to provide them with support, including the most up-to-date diabetes research, technical assistance and watching many of the people involved set and reach the goal of becoming CDEs.
In North Carolina since 2007 these educators have assisted over 5,000 patients with diabetes. Close to 70% of those patients who have completed the program have an A1c of 7% or less. Patients come for an initial assessment, eight hours of group classes and then a one-hour follow up. Although that is considered program completion, the patient continues to be supported through medical nutrition therapy visits, an annual two-hour refresher course and this year we will also add phone and e-mail follow ups to the patients ongoing support plan.
As an ADA recognized program, we are given the ability to access the ADA’s diabetes patient specific data collection software, a program called Chronicle. It is used by our educators to complete initial assessments, track lab results, document attendance in classes, set and assess goals and do document follow up. Chronicle was released in June 2011 and now most of our sites have gone paperless! The use of Chronicle for data collection, makes annual reporting and data collection much easier because all 40 health departments are putting the data in one place.
Due to the program’s success, co-workers and friends nominated me for the AADE Diabetes Educator of the Year. I was pleasantly surprised when I learned in May that I had won the award. I was able to travel to Indianapolis for the presentation of the award and realized the impact that I could have on other educators not only in NC but across the U.S.
Over the past two years I have learned that diabetes can cause hearing impairment and hearing loss. It has been so interesting to learn how diabetes affects the small vessels and nerves in the ear causing hearing loss. What I have also learned is that there are so few diabetes educators who are aware of this complication.
In 2013 as Diabetes Educator of the Year, I hope to be able to share this information, during education sessions, so that educators will make this part of their diabetes self-management education programs. I will share with them the simple screening tool they can use to identify patients who have hearing loss and need a referral to an audiologist for more intense screening and treatment. The screening tool is a survey called the HHIE-S and it’s only 10 questions. It can be completed by the both the patient and caregiver. It is very important for patients to be screened early for this complication of diabetes because the longer a patient is affected by hearing loss, the harder it will be for the patient to process speech, once they can hear again.
My hope is that while attending state-wide annual meetings for diabetes educators around the U.S., I’ll be able to help them figure out how to make hearing screenings part of their practice. I am excited for the coming year, to share what I have learned and learn something new!
Thank you for all you do, Joanne!
Readers: for more on what do to about diabetes & hearing loss, please see our recent “411 info” post on the topic.