This list is ILLUSTRATIVE ONLY and is not a comprehensive listing of all functions and tasks performed by incumbents.
1. Integrates skills and knowledge of pathophysiology, epidemiology, clinical management, cardiometabolic conditions, and self-management of diabetes into clinical practice.
2. Applies the ADCES 7 self-care behaviors (or other program approved DSMES curriculum) to educate and facilitate behavior change.
3. Provides quality DSMES in individual and group settings based on assessed needs. Utilizes appropriate teaching techniques that are sensitive to the learning preferences of the person with prediabetes or diabetes.
4. Completes comprehensive assessments for each patient including emotional and behavioral health, interprets personal health data, develops an individualized care plan based on the patient’s assessed needs and goals and promotes successful self-management.
5. Documents all individual contacts/visits in the Electronic Health Record and outcomes data based according to the guidelines in a timely manner.
6. Collaborates, advocates, and confers other members of the diabetes care team in developing person-centered diabetes plans.
7. Advocates for and supports technology-enabled diabetes education and care, in individual and population health diabetes services.
8. Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with TCC, government and accreditation regulations.
9. Identifies and actively participates in the quality improvement (QI) process and adapts practice/process based on QI findings.
10. Coordinates patient appointments for annual physical examinations and preventive services for patients with diabetes.
11. Conducts annual diabetes chart audit and performs focused audits of indicators of concern as identified by recurrent patterns of occurrence or as directed by the Diabetes Program Manager, TCC Leadership and/or the Quality Management Committee. Also participates in annual grant preparation under direction of program manager.
12. Travels to villages for the purpose of providing DMSES, community education, and foot care clinics.
13. Complies with CAIHC infection control and hazardous materials exposure control policies.