Recorded live at ADCES23, ADCES Immediate Past President Lucille Hughes, DNP, MSN/Ed, CDCES, BC-ADM, FADCES joined The Huddle to introduce ADCES's new strategic plan, and to explain the importance of community involvement and knowing your worth when it comes to diabetes care and education. View ADCES' full 2024-2028 full strategic plan here: adces-strategic-plan.pdf (sitefinity.cloud) Learn more about the plan on our blog: Advance the Expertise of the DCES: A Core Goal of the 2024-28 ADCES Strategic Plan Strategic Plan Goal #1: Improve Access to Diabetes Care and Education: A Strategic Focus for 2024 and Beyond (adces.org) https://www.adces.org/perspectives-on-diabetes-care/adces-perspectives-on-diabetes-care/2023/11/16/growing-and-diversifying-adces-membership-a-longstanding-domain-in-strategic-priorities
Live at ADCES23, ADCES Immediate Past President Lucille Hughes, DNP, MSN/Ed, CDCES, BC-ADM, FADCES joined The Huddle to introduce ADCES's new strategic plan, and to explain the importance of community involvement and knowing your worth when it comes to diabetes care and education.
View ADCES' full 2024-2028 full strategic plan here: adces-strategic-plan.pdf (sitefinity.cloud)
Learn more about the plan in this series of blogs: Advance the Expertise of the DCES: A Core Goal of the 2024-28 ADCES Strategic Plan
Growing and Diversifying ADCES Membership: A Longstanding Domain in Strategic Priorities
Kirsten:
Hello and welcome to ADCES' podcast, "The Huddle: Conversations with The Diabetes Care Team". In each episode we speak with guests from across the diabetes care space to bring you perspectives, issues and updates that elevate your role, inform your practice, and ignite your passion .I'm Kirsten Yehl, Director of Research and Development at the Association of Diabetes Care and Education Specialists. I'm really excited to be live at ADCES23 for this episode, talking with current ADCES President Lucille Hughes about ADCES' new four-year strategic plan which officially kicks off in 2024. Lucille will be touching some of the highlights of the plan and how it illustrates and empowers DCES as members of the overall diabetes care team.
Lucille, welcome to The Huddle.
Lucille:
Thank you, Kristen. So glad to be here.
Kirsten:
So glad to have you, especially because we're at ADCES23 in Houston, which is just fantastic. It's so bustling around here.
Lucille:
I just feel the energy. It's just incredible. In the opening session, the energy was there. People were involved. Now here on the exhibit floor and seeing everyone moving around and all our exhibitors, this is unbelievable. It really is a celebration.
Kirsten:
Absolutely, 50 years.
Lucille:
50 years, our anniversary, 50 years.
Kirsten:
How fantastic. Well, lucky you to be the one that gets to introduce 50 years.
Lucille:
It is, I am very blessed. Trust me, I understand that.
Kirsten:
Okay, we're celebrating 50 years, but also get to celebrate this really cool thing, which is the new ADCES strategic plan, which only comes out every few years. So I am so excited that I got to snag you off the floor to talk about this because it's not easy. You're a busy lady. But you are our current president. So many of us know you, so many of us have the pleasure of working with you and talking with you frequently, but some of us don't, and some of our listeners don't. And I would love if you could maybe just introduce yourself just briefly and say, you know, what is your passion? What drove you to become a DCES? You know, how did really did you end up here?
Lucille:
I'd love to. So yes, I am the current president. I'm blessed to be able to have this role and to be the voice of our members, over 12,000 members in ADCES. So that is a thrill. On top of that, to also be a part of a new strategic plan, I mean it's just the blessings keep mounting and mounting. But I have been around for a long time, right? I have been. So I'm a nurse by training, 39 years. And I ama certified diabetes care and education specialist for close to 36 years. I started out obviously very early on in my nursing career and it happened because I was put in a situation to work in an urgent care setting and the physician I was working with also was an endocrinologist and he was studying for his boards in endocrinology. So I would help him study asking questions and I just said well this is so interesting. When he passed his boards he took me into his practice and said "I want you to work as a nurse in my private endocrinology practice." And within a year, he handed me the certification exam application. He said, "you're going to sit for this. I want you to become a specialist." And that was in 1988. I sat for the first, well, it was not the first, but for me, the first opportunity to become a diabetes specialist. I did that. And then my involvement with ADCES came shortly after that because a colleague of mine I was working with in the hospital thought enough to do what we hope every diabetes care and education specialist does which is reaching out her hand to me to say, "I'm going to a meeting tonight, why don't you come with me? I have some great people for you to meet." That's how it started because one person thought enough to pull me into this circle and hopefully I've done that over and over again for the colleagues, the friends, the relationships I've made over the last 36 years. And it was at my first LNG meeting that I said, oh my gosh, I'm hooked. This is an incredible body of people, because we all shared a common goal, which is, we want to make the lives of persons living with diabetes and now at risk for diabetes better, because we know they can live a very long and healthy life if they have the skills, the tools, and the knowledge to do so. That's what we do. We have the ability, if we can reach those individuals, which is why the strategic plan is so important, we need to increase access to what we do. We want everybody living with diabetes and at risk for diabetes to have an opportunity to meet with a diabetes care and education specialist so that we can impart that knowledge, the skills, the tools so that they can be successful, lifelong success, living with their diabetes.
Kirtsen:
So can I bring you back to 1988? And then thinking about the strategic plan. So that endocrinologist that you worked with reached out to you and said you need to do this. And we think about the partnership right that happens with the endocrinologist and the diabetes care and education specialist, primary care physician, diabetes care and education specialist. How do we reach those people and does the strategic plan help us reach those endocrinologists and primary care specialists into your practice. Is there a potential to do that with this new plan?
Lucille:
Absolutely. Because we're saying we want to increase access, we have to look at how we're going to do that. And of course it is marketing, right? We hope to be out there that individuals, that we can empower the person living with diabetes to seek us out. So that's one avenue. But we also have to enlighten and raise awareness on the part of our providers. Endocrinology, primary care, cardiology, ophthalmology, it doesn't stop there, right? It's all everyone because, unfortunately having diabetes means that you have to include many people, because your journey is going to be a long journey. We want you driving that bus, but there's a lot of people you're going to invite on the bus with you. Of course, the diabetes care and education specialist, but all those other providers, plus some, right, plus some that I haven't even mentioned. So we need to raise awareness to everyone on the bus so that they can forward that message as well and say, "hey, have you seen a diabetes specialist? Let me get you in touch with one." Or, "I want you to call this number and make this appointment." And my role back at home, I am the AVP for diabetes education and program design for Catholic health and we're located on Long Island. We have six hospitals within our health system and I am privileged to have been invited back last April to grow our programs because the health systems are getting this message too because there's so many people, diabetes is a cardiac disease it doesn't stand on its own it impacts a person in so many ways, so the health system said we need to do a better job here. And again, I'm privileged that they thought enough to bring me back to do this work. And we had five outpatient diabetes education programs at that time. Right now, I can sit in front of you and say, we have 12 outpatient programs and I'm growing number 13 and 14 which means that we are committed to expansion of access to the diabetes care and education specialists. We're pushing into primary care. We know that we're needed in endocrinology but that's almost a given. Many people know that. But understanding the value. More than 90% of individuals with type 2 diabetes receive their care in primary care. We need to be there. So put, I call it infusing. So I like to infuse diabetes specialists into the primary care practices, meet the patients where they're comfortable receiving care. Many of them have a relationship with their primary care physician for 30, 40, 50 years. They may be hesitant to go outside and start making new relationships. So put us there. Put us there to meet the individual there. So I think as you had mentioned, we want to empower that individual to call upon us. But the strategic plan says we are growing. We need to allow access to all of us, all individuals living with diabetes so everyone needs to do their part.
Kirsten:
I loved your bus analogy and lots of times I use, and just hearing your work out in Long Island, I like to think of the diabetes care and education specialist as the bridge, right? The bridge to the person with diabetes, the bridge between the community and the health system. You know, there are so many pieces to this puzzle. And I love where you were going with primary care and the strategic plan. And I know we're going to jump into that in a second here. What does that model look like? When you think about primary care and y'know really working with primary care to say "DCES can really enhance your practice, can y'know drive down costs for the health system...What does that model look like for people to implement? Is there a model out there or is there something that can be replicated?
Lucille:
I think the key to that question is really innovation. Trying something new, trying something and you know it's called continued quality improvement. I'm starting something new, right, infusing the diabetes specialist into primary care but I will tell you I've already started tweaking it, it's less than a year. So we're finding, oh this didn't work or maybe we could do it better. I think we are creating the models. And also we want to look at the communities, right? And part of our strategic plan is to grow in diversity. So we want to not only look at, we want our membership to be all inclusive, but we want to make sure that the board is more diverse, that our presence in the community to meet that diverse needs of the community. We're not just talking about what we sometimes think about as far as diversity, how somebody might look. But we're looking at where they live. Do we have enough of us in rural communities, community health centers? Looking at all those opportunities. So I think in primary care, is there a particular model yet? I think we're creating that model. And we need to be open to giving things a try. So if there's a health system that is like Catholic Health that says this is an important venture, we need to do this, don't worry about having to tweak it. Start it. Just do it. Put us out there. I've already changed, let's say, billing models and charge tickets. You know, do we see a person on the same day as the provider? You're not going to have all the answers right away. But the most important thing is that we're trying and every time you try it's because you're making contact with an individual with diabetes. To me, that's the most important thing. And with Catholic Health, they've made a commitment that the bottom line is, are we reaching the individuals that need us? We'll worry about the billing. Of course we want that, right? Because it's a hospital business. But the most important thing that Catholic Health is committed to is reaching the individuals, going out to the communities, looking at how do we reach individuals that don't speak the language we do? Are we providing diverse diabetes specialists to do that, to meet them on a cultural needs level? We're doing all that. So just be innovative and try.
Kirsten:
You know, I think that's what I love about every specialist that I meet in this organization. It's almost like they have to be able to do two different things, which is... you know, understand and follow a path where we're working with people with diabetes. A proven path like this is what works when you're delivering diabetes care and education. But at the same time we're saying go out and be innovators. That's your message right, what I'm hearing loud and clear is go out and be an innovator and not every profession or not every specialty gets to do that. I think we're paving a path in diabetes that other chronic care specialists will be able to follow and it's a really unique position to be in. Just my two cents but...
Lucille:
Yes, yes. Look at it also a little bit like research as I spoke this morning in the opening session. We want to provide research on the value. But we, the diabetes specialists that are the boots on the ground in the communities have to do that research. So look at what you're doing as an opportunity for research. Does it work? And you know we all know, even research that comes out to say, “oh you know what, this model wasn't as effective”, that's positive research. It gives us something, and it helps the next person say, “okay let's learn from that, and how can we do it differently?” It's just get out there and do it. Be innovative.
Kirsten:
And it's okay if it doesn't work, like you just said. And that's implementation science research, right? The implementation informs the current research, and it's a cyclical path, which is, as you know, the strategy of the ADCES research committee or the research track. So I’m so excited that you brought us there and I have to say as the director of research, I am so excited to see research infused throughout the strategic plan. That was one of the most exciting things for me to see. So this might be an opportunity for us to kind of turn our direction to really talk about the strategic plan. And y’know I know this is what you're here to talk about. So maybe, do you wanna walk us through, like, you know, I know that there's three points, like three big points, you've already alluded to some of them. Maybe you can just kind of walk us through each one and like the big ideas.
Lucille:
Great, so this new strategic plan it's gonna start in January, so 2024. Remember, keep in mind that the conversation regarding this new strategic plan actually started in the fall of last year. That's how long it takes to put a strategic plan together and ready to launch in place. And of course we worked with a wonderful organization to help us guide the board to get to this point. So it wasn’t something that was easy but it was something that was important and everybody felt completely invested in this process. We knew we wanted to make it simple. Not that it's going to be simple to do but when things can be understood in a simple form people are more likely to do it right? So we wanted to be easy to understand so we really narrowed it to three main points or goals or focus, whatever words you want to use. 1- improve access to diabetes care and education specialists. So we touched on that during our conversation earlier. In order for us to truly move the needle in the diabetes health spectrum, we need to get to those individuals. Diabetes is different than any other chronic illness. That person needs to understand and have the skills and the tools and the knowledge to make the decisions that are moment by moment. There's no health professional that gets to go home with our individuals and live with them 24 hours a day. So unless they have that information to navigate their disease, unfortunately, they're gonna be challenged and not successful no matter what kind of technology we give them, the best medications in the world, we can give somebody everything. If they don't know what to do with them, they don't understand it, they're not going to be successful. So we want to increase access to our services first and foremost.
We want to work also think about how do we do that? We talked about just raising awareness but we also have to think about government. We have to think about our insurance coverage. That sometimes, many times it impedes that person to come see us. Am I going to have a copay? Is this covered? Do I have a large deductible? That's a really big challenge for us, and understandably so. Not everybody has the financial resources that they can just say, hey, I want to do this and I can afford it. So we really want to make sure that we increase affordability as well. When we're talking about access, it's also affordability. It's also talking about coverage. Because there is an, I don't know, a health system on this planet that wants to, that can afford to do anything for free. Right? We'd love to. I'd love to say that education is free. But it's not. So we need to look at that.
Also the second part, the second goal which is really important is: if we want to increase access, the diabetes care and education specialists, we better ensure that the person that they are, that person is meeting with is knowledgeable, that's working with the most information they can, that they feel that they have, they're increasing their knowledge and I like to use expertise. We don't expect anyone to be a perfect expert in every area of diabetes but at least ADCES can be that resource for them to learn more. Just think about danatech alone with over 20,000 views that we have, right, because that just shows that individuals are eager to get that information. Technology, diabetes, health management is changing drastically every day. So we need to make sure that the person, the diabetes care and education specialist has the knowledge themselves to feel confident and comfortable working with everyone with diabetes.
And then we talked on growing the diversity of membership. We want to bring our members in that are working in all parts of the country. You know, keep in mind, Kirsten, ADCES is the only professional organization that is multidisciplinary. All others have a specific specialty. We are multi-specialty, the only one. So we wanna make sure that our membership takes advantage of that. We don't wanna just be nurses or just be dieticians. We wanna make sure that we have a diverse population of members so that we are ensuring that all areas of diabetes self-management education is covered. Although we all pass the same certification exam, we come to it though with our own specialty. So we want to make sure that our individuals with living with diabetes are at risk for has an opportunity to meet with everybody. We also want to look at we can collaborate with other organizations. We have been working over 50 years with industry. They're such a vital piece to the success of not only ADCES but to that individual because with our collaboration with industry, look at this exhibit hall. It's packed with all of our industry partners. So we go as a diabetes specialist, we go to each of these booths and we come back with information that we then pass right onto the patient, right onto that individual living with diabetes. So we also wanna look at increasing and diversifying our relationships across organizations.
Kirsten:
You know, you talking about the specialty and all the different perspectives that come into the specialty, and come back to that idea of that bridge, right? And you know, there's thousands of people here, right? So you can see the impact thousands of people can make out there in the community. But honestly that's just a tiny percentage of who we need right?. So I’m just gonna bring up something that's just ringing in my head as we walk through the strategic plan. So improve access, advancing the expertise, but how can you improve access and advance expertise if we don't have the numbers? Like to me this just needs to grow and how do we do that? And would that support the strategic plan?
Lucille:
Absolutely, and I think what we're doing on a community, ADCES community, but also our industry partners as well and CBCDE, our certification partner, is we're looking at how we can embrace and bring in, invite to the table, others that are maybe not licensed professionals that are going to sit for the CDCES exam. But looking at what can we do with maybe medical assistants right? Or how about the dedicated person that is serving in a church that has connections to the community that look upon this person as a leader in the community. How can we pull in all those other people and give them an opportunity to be a part of the DCES team? You know we say I'm a certified diabetes care and education specialist, but everyone could be a diabetes care and education specialist. We want to give them, it might look different, their roles are gonna look different, but isn't that wonderful that we have the person, picture person living with diabetes being able to interact with somebody that looks like them, lives like them, cooks like them and have somebody that's going to understand those challenges and then have maybe the expertise in medication management, talking to maybe a pharmacist that is the CDCES. And then bringing in that mental health worker, because you know it is challenging living with diabetes, we talk about diabetes burnout. So we don't want to just look at the professionals. How we grow is we have to be open to saying there's going to be many layers here. What do those layers look like and who can fill those spots? And I'm gonna tell you, my experience is there are so many people that want to raise their hand and say “let me help the person living with diabetes. What can I do? Give me something to do.” So I know they're out there.
Kirsten:
Absolutely. Y’know I have, and I think you've heard the story. But in my Uber ride over here to the conference, my uber driver was named Marcus and he had a nephew that was just diagnosed, nine years old, with diabetes and really talked through the impact it had on the family. And you know, when I talked through like you know, to try to give him resources and what he could possibly do, he was like well I could be a lifestyle coach. And so I think my perspective as I’m talking to and meeting with people is starting to think, there's these Marcus moments right? Like we can't lose those Marcus moments of reaching people and expanding our network because that's how we're gonna really reach people in the community. Well, Lucille this was absolutely a wonderful conversation.
Lucille:
Thank you.
Kirsten:
And I know like you are so busy here so I totally appreciate you just stopping by and letting me grab you to sit down for this quick conversation.
Lucille:
Oh this is great, anytime.
Kirsten:
Well and before we leave, you know I always give people this opportunity to say, you know, words of wisdom, practice pearls. We talk a lot about theoretical ideas. And I know this strategic plan is not theoretical, it's very actionable, right?
Lucille:
Very actionable, correct.
Kirsten:
What would be one or two ideas that you could say to our listeners to say, this is what you can do. Like this is what you can do in your practice, this is the first thing you can do, and it will make an impact.
Lucille:
That's easy. That is easy because I said it in the opening session. We have to be confident, and we need to understand and appreciate our own value. And then we need to voice that value to our health systems, to our industry partners, to our legislators. We have to be empowered to do that. Yes, we want everyone else to talk about how important it is to have a diabetes care and education specialist on the care team. But we, as the DCES, need to raise our hand to say, look at what we can bring to this health team. Look at what we do. We need to have that loud voice, and then we can make a difference.
Kirsten:
That’s fantastic. Well thank you for that message. I've heard it loud and clear. I know our listeners will hear it loud and clear. Enjoy the rest of the conference.
Lucille:
Oh, we will, we will. This is going to be great. More celebrations to come too. Something planned for each day.
Kirsten:
Fantastic. And I hope we can sit down again and have a conversation.
Lucille:
I look forward to it. Absolutely.
Kisten:
Alright. Thanks, Lucille.
Lucille:
Thank you.
Kirsten:
Thank you for listening to this episode of The Huddle. Make sure to download the resources discussed on today’s episode. You can find them linked in the show notes at DiabetesEducator.org/Podcast.
And remember, being an ADCES member gets you access to many resources, education, and networking opportunities. Learn about the many benefits of ADCES membership at DiabetesEducator.org/Join.
The information in this podcast is for informational purposes only and may not be appropriate or applicable for your individual circumstances. This podcast does not provide medical or professional advice and is not a substitute for consultation with a health care professional. Please consult your health care professional for any medical questions.