Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Measuring beyond glycaemia: the importance of other quality indicators (#110)

Trisha Dunning 1
  1. Deakin University/Barwon Health, Geelong, VIC, Australia

Measurement is part of everyday life. It is integral to all aspects of diabetes education and management and the factors that influence the outcomes.  Likewise, measurement is part of health service accreditation processes that measure performance against standards relevant clinical indicators, and it is an essential element of all types of research.  Glycaemia is only a small part of the complex situation that needs to be measured.  Not all valuable measures are or should be numerical.  In fact, it may be more important to measure and understand the issues that are important to people with diabetes and how they affect glycaemia positively or negatively.  Importantly, measurement tool/s used MUST suit the aim or purpose for which they are being used (fit for purpose) and be reliable.  For example, blood glucose, HbA1c and lipids are commonly used as primary outcome measures of diabetes education.  However, there is rarely a direct relationship between education and metabolic parameters; thus, they are at best surrogate markers.  Current best practice advocates individualising care and metabolic and other health targets and notes they are likely to change along the life continuum, different indicators often apply and different/additional measures are required over time.  The impact of new technologies and education methods also influence what we measure and how we measure, collect, store and analyse data.  Importantly, we rarely measure whether health professionals are ‘fit for purpose.’  Knowledge tests, credentialing and ‘patient satisfaction surveys’ do not measure health professionals’ capacity to form and maintain therapeutic relationships, their social and emotional intelligence, or their beliefs, attitudes and behaviours and how these factors influence the care they deliver.  The presentation will discuss ‘measurement’ in diabetes education and management and make an argument for using other measurement processes/strategies besides glycaemia to determine diabetes education and management outcomes and will note differences between measurement for research purposes and accountability, ‘bean counting,’ and measurement to provide holistic person-centred care.