New survey measures diabetes satisfaction

Asking patients How’re we doing?’ gets results

Because surveys are such an effective way to measure satisfaction, a team working with David B. Nash, MD, MBA, associate dean and director of the Office of Health Policy at Jefferson Medical College in Philadelphia, developed a reliable and valid instrument, the Disease Manage ment Evaluation Tool (DMET) — the first of its kind. With the help of a grant from Hoechst Marion Roussel of Kansas City, MO, the DMET team has completed testing the instrument and has a paper containing outcomes data under review by the journal Diabetes Care. The team will continue to test and refine the DMET next year.

In the course of implementing their diabetes health management programs, Jefferson staff discovered one important fact: Patients’ satisfaction with their diabetes program is closely related to their participation. Effective disease management requires active patient participation, and improving upon areas in which patients are dissatisfied is critical to enhancing their level of participation.

The survey tool will enable case managers to assess the satisfaction level of their patients. "Case managers should be interested in our findings," says Nash, "because this survey helps us create better programs and helps patients become more aware of their disease, resulting in bringing down their levels." And once the instrument is copyrighted, Nash says the team will loan it to anyone who wants to see how satisfied their own patients are with their diabetes disease management program.

Why does the instrument work so well? "No one has ever thought to create a tool specifically to check on how satisfied patients are with a diabetes disease management program," says Nash. "Up until now, what they have been trying to do is evaluate the effectiveness of their programs, but no one has ever asked the patient what he or she thinks about them."

"It’s so interesting that no one has asked straightforward questions like, Are we helping you?’ and How are we doing?’ We’re looking at a niche that hasn’t been looked at before," says Lisa E. McCartney, Nash’s assistant project director in the Office of Health Policy and Clinical Outcomes at Jefferson. "Yes, there’s been follow-up, but no one has asked specifically about the disease management program. That’s why this is such an interesting project."

How will these good results affect future disease management programs? "We’ll listen very closely to what patients have to say and see if we can improve our program based on their feedback," says Nash.

The first step in the project was to form focus groups of patients who would generate ideas so the team could develop a questionnaire that measured patient satisfaction accurately. The DMET contains 39 questions in six domains: meetings, general complications, personal nutrition, personal physical activity, time commitment, and acute complications.

The survey includes these questions:

• How satisfied are you that the meeting topics discuss the kind of diabetes YOU have?

• How satisfied are you with the flexibility you have regarding what you can and can’t eat?

• How satisfied are you with your understanding of how depression can change your sugar levels?

Responses can range from "very dissatisfied" to "very satisfied." The instrument addresses process, content, and outcomes of care. Although the three common strategies of glucose monitoring, physical activity, and nutrition are the general focus, the tool’s main theme is to assess how satisfied patients are with what they learn from the diabetes program and how well they can apply that knowledge.

For more information, contact:

David B. Nash, MD, MBA, associate dean and director, Office of Health Policy, Jefferson Medical College, Philadelphia. Telephone: (215) 955-6969.

Lisa E. McCartney, assistant project director, Office of Health Policy and Clinical Outcomes, Thomas Jefferson University Hospital, Jefferson Health System, Philadelphia. Telephone: (215) 955-0748. E-mail: lisa. mccartney@mail.tju.edu.