|Audit & Quality Development
All centres delivering structured education have a responsibility to collect data as part of ongoing evaluation of their programmes. The Network recommends a standard data set is collected at baseline, and then annually thereafter. In addition to bio-medical data (eg Hba1c, weight), it is recommended that the Problem Areas In Diabetes scale is also used.
Type 1 Diabetes
The steering group has developed a simple excel spreadsheet which can be used by centres to collect core data, with additional local data if required. This format will allow data from several centres to be collated for larger scale audits.
The new data collection forms and database are available to be downloaded from the links below. Helen Loughnane (firstname.lastname@example.org) will administer the database for the Network and any queries should be directed to her.
» DEN Type 1 Data Collection Form
» DEN Type 1 Database (Sample)
Type 2 Diabetes
The X-Pert dataset provides a useful format for collection of data to audit type 2 education programmes. This includes the Diabetes Empowerment Scale.
» X-Pert Evaluation Programme
» Diabetes Empowerment Scale
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Quality Assurance Framework
The Diabetes Education Network actively supports the requirement for every centre offering 'structured education programmes' to examine these programmes and those delivering them on a regular basis. The network believes that this approach is vital to ensure continued development of the educators to deliver the programme and for the development of the programme itself. This will require a quality assurance programme to be implemented in each centre providing education.
- The aims of Quality Assurance (QA) are to ensure that the programme you have designed and developed are:
- being delivered as it was designed/intended to be (FIDELITY)
- as good as it could be, ie what changes could be made to improve it
- to ensure it is reaching the people that it is meant to (REACH)
- The QA process will draw on the:
- Curriculum: a clear description of the course, its aims/learning opportunities; the philosophy behind it and learning theories employed; the group it is designed for; the processes that are vital for the successful delivery of the programme (key process indicators of educator behaviour); the preparation and training for educators
- Audit Criteria: the measured current standards of the programme (which may include metabolic, quality of life and educator behaviour data)
- A Quality Development File (QDF) should be maintained by providers for each education programme, to be kept with a copy of the curriculum. It should be updated continually and should include:
- Details of all educators and training received
- Dates and attendance of courses
- Completed participation evaluation and peer review reflection tools (See 4 below)
- Minutes of programme review team meetings
- Audit data updated annually
- Record of any peer review undertaken by other people (see 6 and 7 below)
- The development of 'Programme Review Tools' will support the collection of information for the above. The tools should be developed as questionnaire/reflection tools to illustrate both the key areas to be reviewed and a desired feedback process to support personal and peer review feedback if appropriate. The following tools should be developed for each programme (click for an example of each):
- Participant Data Audit Tool
- Participant Evaluation Tool
- Programme Delivery Review Tool
- Educator Self Reflection Tool
- Peer Review Reflection Tool (internal and external)
- A Programme Review Team should review the course on a regular basis, such as every three months. The review team should include all professionals involved in course delivery and should:
- Discuss recent courses and review participant evaluations
- Review any previous changes to the course
- Review audit data
- Recommend futures changes or improvements
- Regional Review Networks are encouraged as a means of providing a mechanism for independent review of delivery and of audit data in neighbouring centres.
- An External Review could take place for a number of reasons. For centres delivering national programmes, an important role for external review is to ensure consistency with the national curriculum which has been stipulated for that programme. For local programmes, the Diabetes Education Network believes that the duty of education providers is to undertake a robust quality development programme, and to maintain a Quality Development File as outlined above. This is consistent with the advice contained within the DH document "Structured Patient Education in Diabetes"
An external review of a local programme may take place for the following reasons:
In each case, it will be the responsibility of the provider to make available appropriate documentation such as the curriculum and QDF, as well as any other information requested by the external assessor.
- At the request of the provider in order to provide an independent assessment of the service, either to confirm the quality of the service or as a means of solving an identified problem.
- At the request of the commissioner as part of their quality assurance programme, or in response to adverse feedback
- As part of an accreditation process (see below)
- Accreditation is the checking and approval of organisations that validate other oganisations' products or systems In the context of provision of healthcare education services accreditation is defined as 'A voluntary formal process by which an independent body assesses and recognises that an organisation meets applicable, pre-determined standards.' Accreditation of education programmes, to certify the meeting of standards through a 'kitemarked process' can only be carried out by an independent and external organisation. There is currently no organisation that accredits or certifies whether standards for diabetes structured education are met. The new Quality Institute for Self-Management Education and Training partnership (QISMET) is currently developing processes to accredit/ certify organisations providing lay and healthcare professional led self-management and education programmes for all long term conditions. The Diabetes Education Network and Diabetes UK will be actively engaged with the work of QISMET as it develops an accreditation framework for diabetes education.
» Sample Programme Delivery Review Tool
» Educator Self Reflector Tool
» Peer Review Relection Tool