Full Report

DIABETES
Many patients appear to like the collaborative approach
to working with staff, and being respected as a partner
in the care process. 69
The action plans were specifically linked to some of
the first health outcomes – namely changes in patient
behaviour – witnessed by the teams. 70 Interviewees
noted that some patients initiated action plans on
their own. Some other patients attended follow-up
sessions with their providers with goals already
set – often related to items that staff would not
normally have addressed before undertaking SMS
training. In some cases, patients contacted their
providers to report how good they felt – an indication
that patients are engaged and using SMS to help
in the management of their own care. 71
With more time spent on management
and prevention than acute treatment,
staff expect clients to have better control
of their symptoms.
Meeting expectations
The literature shows that people with diabetes who
live in jurisdictions with an integrated, standardized
approach to SMS experience an improved quality of
life from participation in diabetes self-management. 72
Pilot team expectations for patient outcomes align
well with the literature. With more time spent on
management and prevention than acute treatment,
staff expect clients to have better control of their
symptoms. Staff also expect to see overall improvements
in patients’ quality of life and a decrease in
frequency of acute illness. Perhaps most importantly,
staff expect patients and their families to be empowered
in the management of their own disease. 73
According to one staff, SMS will help patients “demand
more from healthcare providers, to ask questions…
When we empower people, they will speak for their
children and their grandparents.”
After only six months of implementation, SMS has
already taken root in the pilot sites. Six out of the
seven diabetes pilot team members interviewed
acknowledged some level of implementation of the
SMS tools into their practice. Action plans, techniques
for increasing patient motivation, agenda setting and
follow-up were specifically identified by different pilot
team members as being beneficial.
“[SMS] is the gold standard for care,
we need to get everyone on board.”
As a result of the buy-in from pilot staff and the
initiation of implementation of the tools, staff are
beginning to see SMS as a valuable approach to
collaborating with their patients to improve diabetes
management. As one interviewee noted, SMS “is now
a philosophy within the program. There is a point
where we were no longer considering this as a pilot
project but a program.” Another interview identified
SMS as “the gold standard for care,” and was adamant
about the “need to get everyone on board.”
Pilot teams achieved significant improvements
in professional practice and organizational development
that have already directly affected diabetes
patients. Pilot teams and department staff achieved
these improvements within existing budgets and
without additional human resources – a testament
not only to staff’s dedication and endorsement
of SMS, but also its practicality and affordability
in the treatment of diabetes.
33
Making the Case for Change