Toolbox

Overview

Our goal is to assemble a thorough and current Web-based list of useful tools and to help diabetes health care providers and planners find them, select appropriate tools, and implement them effectively into practice.

As a chronic disease, diabetes presents a long-term, multi-factor clinical challenge to health care professionals as well as people with diabetes. Effective use of tools in the management of diabetes can empower physicians and other primary care providers to make good clinical judgments, involve patients in self-management, and provide timely, efficient, cost-effective care - all of which contribute to improved outcomes, including the well-being of people with diabetes.

Who selects the tools?
Members of the National Diabetes Education Program (NDEP) Health Care Provider Work Group review and select the listed tools. The work group is made up of volunteers from a number of health professional, government, and consumer organizations. Members of NDEP's partner organizations also may review the tools selected.

The NDEP is a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention. This federally sponsored initiative involves public and private partners to improve the treatment and outcomes for people with diabetes, to promote early diagnosis and, ultimately, to prevent the onset of diabetes. NDEP work groups and other partner organizations contribute to the development of NDEP products.

Who could use the tools?
The tools are intended for use by health care professionals and clinical administrators at all levels of health care delivery, including small free-standing practices, large group practices, Preferred Provider Organizations, Health Maintenance Organizations, and Network administration.

How are the tools selected?

• Tools are selected if they support the current state of the art of comprehensive diabetes health care delivery and have been used effectively in evidenced-based, clinical practice to improve diabetes care. It should be noted that it might be difficult to separate the effectiveness of the tools from other simultaneously bundled interventions.
• No evaluation or ranking has been or will be conducted.
• NDEP does not endorse any tool that has been selected. We note that an exhaustive search has not been conducted, and that worthy tools may, therefore, have been omitted. As other appropriate tools come to our attention, they will be added to the site.
  

What information is listed?

• A brief description is provided to help users determine tools of interest. The creators and source of each tool are identified. In most case a direct website link connects the user to the tool(s). If no website link is available, the material is in a PDF file.

How can these tools be useful?
There are several caveats that should be kept in mind for users selecting tools for their practice.

• Successful implementation is the key to success with any tool. No matter how simple the tool, some level of systems change will be necessary for it to be used effectively. For example, the implementation of "standing orders" for defined elements of diabetes management requires: physician agreement on the orders; placement of the orders in the appropriate medical records; awareness and cooperation of team members who will carry out the orders; delineation of any required procedures; and periodic evaluation of the content of the orders and their utilization.
• Reviews of interventions to improve the management of diabetes in different settings indicate that multifaceted efforts are more likely to succeed than single, one-purpose efforts.1 2 For example, use of a diabetes management algorithm combined with team care and a system to remind patients about follow up appointments is likely to be more effective than any of the efforts implemented separately.
• No intervention is consistently effective for all services and all settings, and some will be more appropriate than others in different settings. To be most effective, interventions need to address the barriers that are specific to the service and the setting and take into account the cost and difficulty of implementation.

How do I use this toolbox?

• Select tools that meet particular needs, download, and update and tailor them as necessary prior to implementation.
• Review and update the clinical data on any selected tool to be consistent with current American Diabetes Association Clinical Recommendations that are updated annually. Individualize recommendations as necessary for individual patients.

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