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Similar a Fall 2009 Hod Presentation Ebp And Health Reform
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Fall 2009 Hod Presentation Ebp And Health Reform
- 12. Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted. Albert Einstein
- 15. Uninsured Texans
Notas del editor
- Feel free to delete, add, or edit slides to make this presentation useful for you and your audience. On the last slide insert your email or phone number for any follow-up questions or comments. Delegates prior to presentation: Make copies of HOD Member Fact Sheets Member Input Collection form- These forms will allow members to list their responses collectively or individually. Collect responses by Friday, October 9, 2009.
- Outstanding Nutrition Education Award-- Member who has made a major contribution to nutrition education of the public and/or health professionals on a state ,national or international basis. The ADA Board of Directors, Commission on Dietetic Registration and House of Delegates approved this revised Code in April and May 2009. The 2009 Code of Ethics was published in the August 2009 Journal of the American Dietetic Association (pages 1461-1467). You can access the Code on the ADA Web site at www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_779_ENU_HTML.htm The 2009 Code is effective as of January 1, 2010. Ethics Educational Resources Available In addition to the published Code of Ethics, a variety of educational resources have been posted on the ADA Web site to assist practitioners to understand the application to practice. These resources have been developed by the ADA/CDR Ethics Committee. The Ethics Committee is focusing their attention on providing educational opportunities for practitioners to increase knowledge and understanding of the Code of Ethics. Please join me in thanking the members of the Ethics Committee for their efforts to develop these resources. These resources include: Ethics Video Series: Ethical Dilemmas in Dietetics Practice – A series of videos are provided which present five different case studies and a set of questions to be To access this video series, please use the following link: www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_22785_ENU_HTML.htm Ethics Case Studies: Learning Application for the 2009 Code of Ethics - A total of 24 case studies are provided for use by practitioners To access these case studies, please use the following link: www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_22793_ENU_HTML.htm In the future, watch for two addition resources to be made available to practitioners: The Code of Ethics for the Profession of Dietetics-Trainer’s Guide This training guide will be updated during November and December 2009 and is tentatively scheduled for publication in January 2010. Doing What Is Right: Ethical Applications in Dietetics A teleseminar has been scheduled for January 22, 2010 entitled “Doing What Is Right: Ethical Applications in Dietetics” and will feature Marianne Smith Edge and Jana Kicklighter, members of the Code of Ethics Task Force, as the presenters.
- Review the Definition of Mega Issues: Mega issues are overriding issues of strategic importance, which cut across multiple goal or outcome areas. They address key strategic questions the organization must answer, illuminating choices the organization must make and the challenges that will need to be overcome in moving toward the envisioned future. They articulate the questions that will need to be asked and answered by the Association in the next 5-10 years.
- Members can obtain CPE for reading HOD backgrounders and discussing them using the Study Group format (see Continuing Professional Education Guidelines p 7; Professional Development Portfolio Code 160) or Journal Club format (see Continuing Professional Education Guidelines p 12; Professional Development Portfolio Code 230). Continuing Professional Education Guidelines: http://www.cdrnet.org/PDFs/2008%20Guide%20CPE.pdf Using these methods, members read the backgrounder and then get together as a group for a discussion. For more information, please see the guidelines as references above. Note, no certificates are provided for these formats. Completion is self-reported. During the Fall 2009 HOD Meeting, October 16-17, 2009 in Denver, Colorado, delegates will dialogue on the two issues as noted on the screen. Topics: Mega Issue: Evidence-based Practice The first is considered a Mega Issue which is defined as an overriding issues of strategic importance, which cut across multiple goal or outcome areas. Mega issues address key strategic questions the organization must answer, illuminating choices the organization must make and the challenges that will need to be overcome in moving toward the envisioned future. They articulate the questions that will need to be asked and answered by the Association in the next 5-10 years. Health Reform As you all know, health reform is at the forefront of issues being addressed by the current administration. It is important that RDs and DTRs are included in legislation that will occur related to health care in this country.
- Mega Issue Questions How can delegates, members and ADA organizational units foster the incorporation of evidence-based practice in all areas of dietetics? What opportunities exist that would encourage incorporation by members? Review the question on the screen.
- Expected Outcome RDs and DTRs in all areas of dietetics will employ evidence-based practice to position the profession for improved reimbursement, recognition, and quality services when appropriate. Review the expected outcome on the screen.
- Evidence-based practice (EBP) “is an approach to health care wherein health practitioners use the best evidence possible, i.e. the most appropriate information available, to make decisions for individual patients”. EBP values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. It involves complex and conscientious decision-making based not only on the available evidence but also on client characteristics, situations, and preferences. It recognizes that health care is individualized and ever changing and involves uncertainties and probabilities. Key Considerations: It is practice based on successful strategies that improve client outcomes and are derived from various sources of evidence including research, national guidelines, policies, consensus statements, expert opinion, quality improvement data and client preference. Evidence-based practice is about decision making in daily practice. Placing the client’s benefits first, providing evidence based practice requires adopting a process of lifelong learning that involves continually posing specific questions of direct practical importance to clients, searching objectively and efficiently for the current best evidence relative to each question, and taking appropriate action guided by evidence. "Evidence-Based Health Care extends the application of the principles of Evidence-Based Medicine to all professions associated with health care, including purchasing and management".
- Why is evidence-based practice important? Explosion of literature: Health care literature is published at a rate that is impossible for individual clinicians to keep up with. By using evidence-based practice (EBP) resources, evidence-based decisions can be made in a focused and time efficient manner. Unmet information needs: Information needs of practitioners are not currently being met. Questions from patients, clients and other stakeholders are continuously being generated. Due to lack of time, lack of information resources, limited search skills, and limited funding, many questions go unanswered. Synthesized EBP resources are easy to use and help to quickly connect evidence-based answers to questions. Implementation delays: Research findings are often delayed 10-20 yrs in implementation. EBP resources take into account evidence from a wide variety of fields and provide an opportunity for greater exposure to evidence. Evidence-based practice is also important due to the possibility that it will standardize practice so that outcomes data can be collected and analyzed to continue to improve the quality and effectiveness of practice.
- Published Position Papers using evidence analysis approach: Weight Management (2009); Nutrition and Athletic Performance (2009); Health Implications of Dietary Fiber (2008); and Individual, Family, School, and Community-based Intervention Programs for Pediatric Overweight (2006). In Development: Promoting and Supporting Breastfeeding Fortification and Nutritional Supplements Vegetarian Diets Nutrition Across the Spectrum of Aging Impact of Fluoride Health Use of Nutritive and Non-nutritive Sweeteners Only 5 of 28 Dietetic Practice Groups have published articles discussing evidence-based practice in their newsletters The Journal of the American Dietetic Association Articles in which the topic matter is directly reflected in ADA's Evidence Analysis Library include the following icon, directing members to ADA's library. At least one article each month bears this icon. ADA Foundation The Foundation provides funding support as it relates to evidence base research. Funding has been provided for sections of the EAL, the Dietetic Practice-based Research Network (DPBRN) and named research awards. For example the Foundation funded Childhood Overweight, Vegetarian Nutrition and Spinal Cord Injury projects.
- Book Publishing Research: Successful Approaches, 3rd Edition is a text that ADA publishes and is designed to help RDs plan, execute and report research. Chapter 12: Systematic Reviews to Support Evidence-Based Practice specifically addressed EPB. Evidence-based Practice Committee (EBPC) The committee oversees the development and implementation of evidence-based practice, including the evidence analysis process development and maintenance of the Evidence Analysis Library, development and publication of all Evidence-Based Nutrition Guides for Practice (including those for Medical Nutrition Therapy) and other products based on the results of evidence analysis. Evidence-based Practice Guidelines & Tool Kits 2001: First guidelines developed by ADA on 4 topics: Diabetes Type 1 and 2, CKD, Gestational Diabetes, Hyperlipidemia. Obtaining reimbursement for MNT for Diabetes and CKD was tied to having these in place to show that RDs can achieve expected outcomes. 2004: Launch of EAL- with 3 topics; today there are over 36 projects in various stages. Content has grown tremendously. This includes over 3400 articles analyzed, questions, evidence summaries, recommendations, most popular pages, top searches, page views, ADA members logged on, etc. 2005: Evidence-based Practice Committee established to oversee evidence-based practice initiatives. Much of their work has been involved in the dissemination of the EAL- presentations/workshops at FNCE, DPG meetings, affiliate meetings, Dietetic Educators of Practitioners (DEP) DPG meetings, and external meetings. Products/tools resulting from evidence analysis projects include: educator modules, Evidence-based Toolkits and evidence-based presentations which are available on the EAL store: https://www.adaevidencelibrary.com/store.cfm
- If we lack evidence to support our practice decisions, how can the RDs and DTRs achieve the goals we have set for ourselves to be the preferred supplier of food, nutrition, and health services? Dietetics must rapidly become a truly evidence-based practice profession, utilizing a systematic, standardized care process such as ADA’s Nutrition Care Process and carefully evaluating outcomes. If we fail to enhance our evidence-based practice, we likely will find ourselves locked out of opportunities we have worked so hard to create, including jobs, recognition, and compensation. But also keep in mind…The Center for Evidence-based Medicine states that “good doctors and health professionals use both individual clinical expertise and the best available external evidence, and neither alone is enough.
- Let me know about EBP success stories so I can share them at the Fall 2009 HOD Meeting (October 16-17, 2009 in Denver, CO). Member input is needed to help form the foundation for identifying a range of barriers to evidence-based practice. Please respond to the following questions: What sources do you use to solve problems in practice (i.e. EAL)? What types of questions do you have regarding evidence-based practice that is not answered in the Backgrounder? Provide responses to your delegate by Friday, October 9, 2009 . Delegate contact information: [Insert your contact information]. You can also send a direct email to [email_address] .
- America is facing a health crisis. For decades the Congress and Presidents alike have struggled with how to reform health care. In 1945, Harry S. Truman gave a speech to the United States Congress proposing a new national health care program. In his speech, Truman argued that the federal government should play a role in health care, saying "The health of American children, like their education, should be recognized as a definite public responsibility." Ever since that time, the debate over health care has continued. Even with passage of Medicare and Medicaid in 1965, health care has remained a major issue facing America. Today few would argue that our health care system is functioning well. The issues involved are complex and multifaceted: • There are 47 million Americans without health care coverage. • Access to health care is often dependent on the patient’s insurance status and policy. • The current system of coverage that is provided by employers is not flexible enough to meet peoples’ needs. • Providing health care insurance to employees is making American companies non-competitive. • Both Medicare and Medicaid are fiscally unsustainable. Dissatisfaction with the U.S. health care system is prevalent among patients and health care providers alike .
- Texas has the nations highest rate of uninsured and there are 4 districts among the worst 10 in the country for constituents who lack coverage. Not a single Texas congressional district, even the state’s wealthiest, ranks in the nations top half. Hearst analysis of Gallup Poll data compiled by National Journal
- Review the discussion question on the screen.
- Review the Expected Outcomes. Expected Outcomes: Attendees will: Collectively better understand what is going on at the state level. Better understand ADA’s legislative efforts. Link state level activities with national activities. Develop strategies that can be utilized in your own state or area of practice.
- Health Care Reform Released in December 2008 by the American Dietetic Association’s Health Care Reform Task Group, Health Care Reform set tenets by which ADA will analyze and critique national health reform proposals. Efforts will focus on preventive and interventional health promotion and care, highlighting the role of the registered dietitian in maintaining health and wellness, disease prevention, and chronic care management throughout the continuum of life – from prenatal to end-of-life care. These tenets are as follows: The health of all Americans should improve as a result of our health policy choices. Sufficient resources must be made available to ensure optimal health. Access to quality health care is a right that must be extended to all Americans. Nutrition services, from prenatal through end of life, are an essential component of comprehensive health care. Stable, sufficient, and reliable funding is necessary for our health care system to provide everyone access to a core package of benefits. Health care must be patient-centered.
- ADA convened an internal Patient-Centered Medical Home Work Group to gather and assess information related to RDs current involvement in this model of care and to develop a strategic plan for engaging members in this model. Patient-Centered Medical Home Definition The PCMH is a model for care provided by physician practices that seeks to strengthen the physician-patient relationship by replacing episodic care based on illnesses and patient complaints with coordinated care and a long-term healing relationship. Each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician-led care team is responsible for providing all the patient’s health care needs and, when needed, arranges for appropriate care with other qualified physicians. The PCMH model has been proposed as a model of health care to be implemented with health reform. It is a preferred model by many and needs to be considered by ADA in moving forward with health reform. The role of the RD needs to be addressed to ensure that we are part of this model if it is chosen.
- Patient-Centered Medical Home Strategic Plan Patient-Centered Medical Home Strategic Plan released by the Patient-Centered Medical Home Work Group recommended the following goals with strategies further outlined in their May 2009 report: Goal #1: Current and future RDs are empowered to advocate for inclusion in the patient centered PCMH and other health care models as the preferred provider for food and nutrition services. Goal #2: The PCMH providers value and choose RDs as preferred providers for food and nutrition services.
- Infrastructure to Support ADA Public Policy ADA’s infrastructure to support our public policy mission through grassroots involvement includes every member. Key persons in grassroots work include: Public Policy Coordinators (national issues), State Policy Representatives (state issues), Public Policy Panels (Affiliate Presidents, PPCs, SPRs and others) DPG Legislative Chairs or Public Policy Liaisons ADAPAC (Political Action Committee) Legislative and Public Policy Committee (national committee) Policy Initiatives and Advocacy Team staff ADA Communications ( On the Pulse , Journal of the American Dietetic Association , and ADA Web site).
- Ask this question of the audience. You can use the Member Input forms. Delegates have used the forms two ways – pass a form out to each meeting participant and collect at the end of the presentation OR have one participant act as the recorder for the discussion and collect the information on one form.
- Insert your email or phone number on this slide for any follow-up questions or comments Delegates are collecting member input on both issues; hopefully today you can provide me with your feedback. The feedback and input received regarding Evidence-based Practice will be posted to the HOD CoI (which is the Web site used by the House for it’s work and communications). All delegates will be reading posts in advance of the Fall 2009 HOD Meeting. For the Evidence-based Practice Mega Issue, members can give feedback directly to you(r) delegate or use the email address above which will directly post comments regarding EBP to the HOD CoI for all delegates to read. The information that delegates collect regarding Health Reform will not be posted to the HOD CoI prior to the Fall 2009 HOD Meeting. Rather, delegates will be summarizing the information received and collected and bring it to the meeting to share with delegates from similar regions. For both discussions, member input is needed to help build on the foundation of knowledge regarding these issues. The backgrounder is the first step in building the foundation and member input is the next building piece. Thank the audience for participating in the discussions.