TABLE 1

Factors Contributing to Therapeutic Inertia in Diabetes Education and Proposed Actions to Address Them

Contributing FactorsProposed Actions
Educator burnout
  • • Focus on things you are passionate about

  • • Maintain a healthy work-life balance

  • • Embrace health-system leadership transparency and encourage the clear delineation of professional roles to enhance efficiency and effectiveness

Changing standards of care
  • • Stay up-to-date with new guidelines

  • • Discuss new research, clinical trials, and guidelines with other members of the interprofessional diabetes care team

  • • Advance treatment even when A1C, glucose levels, and other laboratory parameters are near goal, which may include incorporating the use of technology

Reduced educator self-confidence
  • • Ask patients for feedback on what they have learned and what changes they have made after education sessions

  • • Meet with providers to discuss services and provide outcomes data on the value of diabetes education

  • • Share information with team members and follow up on laboratory values and clinical outcomes of referred patients

Patient-related factors
  • • Develop a trusting relationship with patients

  • • Schedule patients more frequently

  • • Make information simple

  • • Engage in motivational interviewing

Communication barriers
  • • Connect regularly with providers and other members of the interprofessional team

  • • Coordinate care with other team members

  • • Consider joint visits with other team members

Suboptimal health care models
  • • Take advantage of new reimbursement models to incorporate telephone-based and virtual visits to enhance convenience and improve access to care

  • • Work with leadership on streamlining EMR documentation, scheduling, and job expectations