The Multidisciplinary Team History

Over a decade or more ago, the multidisciplinary team began to be recognized as an effective and efficient method of care delivery and provider of the educational support demanded by

TABLE 1 Guidelines for Scope of Practice for Diabetes Educators American Nurses Association, Scope and Standards of Diabetes Nursing, 1998

American Association of Diabetes Educators, Scope of Practice for Diabetes Educators and the Standards of Practice for

Diabetes Educators, 2005 American Dietetic Association, Standards of Professional Practice for Dietetics Professionals, 2005 American Diabetes Association, Clinical Practice Recommendations, 2006

Task Force on the Delivery of Diabetes Self-Management Education and Medical Nutrition Therapy, 1998 report diabetes. This team approach does not eliminate the primary practitioner or sole practitioner (8), but instead supports the variety of skills, timing, assistance and prerequisites brought by each of its members. The team brings a variety of services, interventions and assistance to fully integrate into a person's lifestyle as needed. Effective teams serve the population whether they are rural, inner city, small or large practice, inpatient or clinic-based, special population needs, etc. They may have a patient-centered or population-based focus. Few other diseases demand such a level of attention. In general, the less the person is educated, the less adherent they are to treatment, and the more (team) effort is required (12). The team is formed by a stepwise process:

■ Ensure commitment of leadership

■ Gain support from care-providers

■ Identify team members

■ Identify the patient population

■ Stratify the patient population

■ Assess resources

■ Develop a system for coordinated, continuous, quality care

This process focuses on common goals, each member airing opinions and contributing to decisions about patient care and education. Efficient care delivery to all patients focuses on care delivery itself, mechanisms of identifying high-risk patients, cost-effective methods of education, and treatment in the outpatient setting (12).

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