Capability Framework for Diabetes Care: A health workforce investment

Abstract

Background: Diabetes has become more prevalent, and technologies and medicines used to manage it more complex. Over a quarter of consumers accessing health services daily have diabetes and access health professionals with varying levels of diabetes-specific knowledge and training. Consequently, they receive conflicting advice, which leads to consumer disengagement. Aim: To develop a national consensus framework to guide their training by identifying capabilities required by health professionals to deliver diabetes care. Method: A 3-staged modified-Delphi technique gained agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage-I) a consultation period, including a semi-structured consultation group and pre-Delphi pilot, (Stage-II) a 2-phased online Delphi survey, and (Stage-III) an external appraisal period, including a semi-structured focus group and health professional regulatory and training organisations survey. Descriptive statistics and measures of central tendency were calculated to determine participant and quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Results: Eighty-four diabetes experts were recruited from nursing and midwifery (n=60[71%]), allied health (n=17[20%]), and pharmacy (n=7[9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care (assessment, diabetes self-management education, therapeutic relationships, communication, counselling, quality use of medicines and diabetes technologies, research/quality), and 2 to 16 statements attained consensus for each capability, 259 in total. Three sets of attributes underpinned the capabilities: support excellent communication, collaboration and advocacy; strive for excellence and promote health professionals’ health and wellbeing to foster their adaptability in dynamic environments. Conclusion: The rigorous consensus methodology led to the design and validation of a Capability Framework for Diabetes Care, which addresses workforce enablers identified by the Australian National Diabetes Strategy. It recognises diversity, creating shared understandings of diabetes across health professional disciplines