Creating Strong Diabetes Program: Plan A Trip To Success!

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Indian Health ServiceCreating Strong Diabetes Programs:Plan A Trip to Success!A Workbook for Program Planning and EvaluationSpring 2010Indian Health ServiceDivision of Diabetes Treatment and Prevention5300 Homestead Road NEAlbuquerque, New Mexico 87110www.diabetes.ihs.govIndian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-1-

TABLE OF CONTENTSHOW TO USE THIS WORKBOOK .4LET’S GET STARTED PLANNING! .6Introduction.6Training objectives .6WHERE ARE WE HEADED? OVERVIEW OF PROGRAM PLANNING .8Why Plan? Part 1 - Planning a Program is Like Planning a Trip.8What is program planning?.8What is program evaluation?.8Importance of Planning for Your Community .9Who Needs to Plan? Part 2 – Who needs to Plan and How to Get Started .10Who needs to do program planning? .10When to get started? .10Planning and Evaluation Checklist Tool.11Tool Tips and Checklist Tool .12VISUAL PLANNING TOOL (OR ROAD MAP).14WHO TO BRING AND WHAT TO PACK! RESOURCES .15Resources Tool.16PICKING THE BEST ROUTE: ASSESSMENT.17What is a Needs Assessment? .17How does a needs assessment affect your diabetes program’s activities? .17Needs Assessment Tool .18THINGS TO DO: ACTIVITIES.19THINGS TO DO: BEST PRACTICES .20Activities Tool.21DON’T MISS THIS! GOALS AND OBJECTIVES .23Goals .23Objectives.23SMART objectives.24Writing Goals and Objectives Tool .25Examples of Words to Use in SMART Objectives Tool.27HAVE WE ARRIVED? RESULTS .29Importance of Keeping Track .29KEEPING TRACK OF DATA (OR INFORMATION) .30Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-2-

Importance of Data or Information .30Types of Data to Collect .30What data to collect .31When to collect data .32DATA.33Making sense of the data you collect .33Keeping Track Tool.34MOVING FORWARD: LESSONS LEARNED.36Timeline or Schedule of Events .36Lessons Learned Tool .37Timeline Tool.39APPENDIX 1 .40Example of Planning .40APPENDIX 2 .44Additional Resources on Planning and Evaluation .44APPENDIX 3 .46Course Information.46Activity Overview: .46Description: Plan a Trip to Success! .46Training objectives .47Continuing Professional Education (CE) Credit Information.47ACCREDITATION:.47Disclosure Statements.49Hardware/Software Requirements: .50Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-3-

How to Use This WorkbookWelcome to the IHS Division of Diabetes training on Program Planning and Evaluation. This training andcorresponding workbook offer an introduction to the concepts and processes of planning and evaluating adiabetes program. We hope that after taking the training and following this workbook, you will be able touse the tools provided for program improvement. You will learn how program planning and evaluation canhelp make your diabetes program be more effective and you will be able to develop plans to evaluate boththe implementation (process) and outcomes (results) of your diabetes program.Challenges and Barriers to Program PlanningWe know that there are many challenges and road blocks to planning a program. Some of these include: Lack of support from administration.Lack of resources (space, staff, money, skills, and others).Lack of data.Fear of change.Lack of time.Working Collaboratively Can Reduce the ChallengesAn effective way to handle the challenges is to work collaboratively. This means working together as ateam with shared decisions about the diabetes program and where it is headed.Recommended Process for the Training Get your diabetes team together and select a group leader (i.e., diabetes coordinator, ADC). Ask team members to set aside at least one-half day. You may want to spread this training over aweek or two. Use this workbook along with the online training. In the workbook, read "How to Use this Workbook" and "Introduction". The online training supports theworkbook through the use of short videos. The online training that accompanies this workbook has one or two videos for each section thatintroduce the topic and show a diabetes team working through the section. The online training provides Essential Elements, or detailed information, and the Quick Facts providethe key points for each section; all of which is derived from the workbook. Use the Action Steps in the workbook or online to fully complete each section. When you complete the training and workbook, you will have a completed planning and evaluationproject for your diabetes program.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-4-

About this Workbook Even though the focus of this workbook and web-based training is geared towards planning a diabetesprograms, the information provided in this training can be useful for many types of programs. Use this workbook as a stand-alone guide to help create and develop a diabetes program plan with anevaluation component for your diabetes program This workbook is also a part of the online diabetes program planning es/index.cfm?module trainingWebBased A planning template and blank forms are located throughout the workbook when you need them. Youmay want to provide each team member with a workbook and a copy of the road map (or visualplanning tool) to guide your diabetes program’s development. You may want to make several copies ofthe blank template and forms to allow for adjustments and updates to your diabetes program plan overtime. The appendix includes a completed sample that you can use as an example.Action! The word action appears at points in the workbook at which you should take action.Tools.Tools are found in tables throughout the workbook.Workbook sections. Cartoon icons indicate a new section of the workbook.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-5-

Let’s Get Started Planning!IntroductionChanges are occurring in the IHS Special Diabetes Program for Indians (SDPI) grant programs. This is atime of transition and requirements are changing. Many diabetes programs conduct a lot of interestingactivities but may not be as productive as possible or may not be able to show their accomplishments andresults. The “old” way of doing things focused on reporting activities. Now, however; SDPI grant programsmust measure, document, and report on outcomes (results). Often they conduct activities without using aguide (a plan) or collecting the right data or information to show that their efforts are successful (anevaluation).SDPI grant programs will need to adapt and learn new skills to be accountable and to show results. Theywill need more than ever a structure for planning and evaluation, and using proven effective strategies suchas the Indian Health Diabetes Best Practices.It’s important to understand why planning and evaluation are needed and why now: Funding requirements Diabetes program accountability Demonstrate results (outcomes)Planning a diabetes program is an important responsibility. This training offers: information and tools for identifying and getting stakeholders involved in the diabetes program assessing community needs selecting effective activities based on your needs showing results demonstrating how resources were usedTo make the process of planning a little bit more “user friendly” we use an analogy: that planning adiabetes program is like planning a trip. We hope this description helps you understand the concepts ofplanning and provides a little fun along the way too.If you are an experienced planner, you may already realize that your diabetes program could be moreeffective. We encourage you to review what you are doing by following the steps in this training. We feelconfident that you will have good results. The web-based, information, and tools are available to you atyour convenience.Training objectivesIndian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-6-

1. Define planning and state why planning a diabetes program is necessary2. State how to identify and engage stakeholders involved in the diabetes program.3. Assess the diabetes needs of your community.4. Select diabetes activities that are shown to be effective.5. Write a goal and an objective for your diabetes program.6. State the importance of documenting activities, results and how resources were used.7. Develop a plan for your diabetes program using a visual planning tool (or road map).Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-7-

Where are we headed? Overview of Program PlanningWhy Plan? Part 1 - Planning a Program is Like Planning a TripThis training is called “Creating Strong Diabetes Programs: Plan a Trip to Success!” We often don’t thinkabout it, but we all use planning and evaluation in our daily lives. We plan what we will eat for breakfast,what we will wear, what things we have to do, if we have enough gas in the car, what we will eat for dinner,and so on. Planning is an essential part of our day.Planning a diabetes program is like planning a trip. We need to determine where we are going, who isgoing, how we will get there, how much money we have and what we will do and so on.Planning requires extra time and energy. But remember, your hard work is going to benefit patients,those at risk of developing diabetes and your community. So let’s get started planning a diabetesprogram.What is program planning?Program planning is a process that can help your diabetes program develop, implement, and evaluateinterventions using proven activities and strategies. This process includes how to document results andshow how resources were used.What is program evaluation?Program evaluation is the systematic examination and assessment of a diabetes program to gather orcollect information that can be used to make improvements, demonstrate accountability, and show results.Program planning and evaluation are needed throughout the entire life of a diabetes program – from startto finish. Spending time and effort now to create a diabetes program and evaluation plan will make yourwork easier in the long term.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-8-

Importance of Planning for Your CommunityDiabetes programs need to develop a plan with an evaluation component before the diabetes programstarts in order to: Make rational choices based on relevant information, previous experiences, and communitypreferences and needs. Reach members of the community and give them skills to engage in healthier behaviors. Provide proven and effective activities to ensure the best possible results. Document how resources were used. Document activities that were done. Document results achieved Determine if a diabetes program is making a difference. Revise diabetes programs that are not as strong as they could be.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011-9-

Who Needs to Plan? Part 2 – Who needs to Plan and How to Get StartedWho needs to do program planning? All those who conduct health and/or diabetes programs, including: nurses, doctors, health educators,dietitians, health specialists, community health representatives, support staff and others. All those who make policies for health and/or diabetes programs, including health departmentadministrators, program managers, health directors, and others.Everyone plans and everyone should have a role in program planning.When to get started?Program planning and evaluation take place when you start thinking about your diabetes program. Whenthinking about a trip, you cannot wait until the end of your trip to start the planning or evaluation process.Planning a trip starts the moment you get the idea of taking a trip. The planning and evaluation processmust be started when the diabetes program is just an idea.Using the Visual Planning ToolWe created a visual planning tool (page 14) as a companion to this workbook. A visual planning tool ismuch like a road map; it can help your diabetes program identify where it wants to go and how to get there.A visual planning tool (or road map) consists of 5 elements:1.2.3.4.Resources (inputs or what is invested).Activities (things a diabetes program does).Products (who was served, what was developed).Results or outcomes of a diabetes program including learning: awareness, knowledge, skills andactions such as behaviors, practices, decisions, and policies.5. Impact or the long-term consequences (social, economic, environmental) of a diabetes program.Using the visual planning tool along with the workbook will help your diabetes program keep track of all theelements of the diabetes program and understand how the diabetes program will work. When you havecompleted the Visual Planning Tool (or road map) you will be able to read your diabetes program planjust like a book.Action! Go To: Planning and Evaluation Checklist Tool. Print it out now and check off every tool asyou complete them.Action! Go To: Tool Tips and Checklist. Determine what is already available to your diabetes program.Action! Go To: Visual Planning Tool (or Road Map) Print it out now and complete the different sectionsas you go through the training. Be sure to make copies for all team members.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 10 -

Indian Health Division of Diabetes Treatment and PreventionPlanning and Evaluation Checklist ToolDiabetes Program NamePrepared ByToolsTips ctivitiesGoals stionsDid you determine what isalready available to yourdiabetes program?Did you print it out?DateStatus(check ifdone)Comments and ActionsNeededDid you make copies for all teammembers?Did you identify stakeholders?Did you determine resourcesavailable?Did you conduct a needsassessment?Did you prioritize needs?Did you come up with potentialsolutions?Did you learn about bestpractices?Did you identify a goal?Did you write a goal?Did you identify an objective?Did you write a SMARTObjective?Did you answer the questions tohelp you decide what data orinformation to collect?Did you complete all the rows ofthe visual planning tool?Did you read your plan?Did you create a timeline to makesure that projects are completedon time?Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 11 -

Tool Tips and Checklist ToolGet started with your plan. See what happened before. Learn from previous successes. Learnfrom previous challenges. Work with your diabetes team and complete this checklist. You will findthat this activity may take additional time to track down all the information.1.History checklista) Has planning been done before? Yes or Nob) If yes and there is an existing report, take the following actions: Locate it. Review it. Talk to the authors. Find out what worked. Find out what did not work. Use it as a starting point.c)If no previous report exists find and review the following: Other agencies reports. Related reports online.d) Has evaluation been done before? Yes or Noe) If there is an existing report do the following steps: Locate it. Review it. Talk to the authors. Find out what worked. Find out what did not work. Use it as a starting point.f)If no existing report exists, find and review the following: Other agencies reports. Related reports online.g) Is there someone who was involved in the diabetes program before and is notinvolved in the diabetes program now? Yes or No.h)If yes, talk to them and find out if they can help the diabetes program and in whatways they are willing to help.i)If no, talk to your Area Diabetes Consultant.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 12 -

2.Constraintsa) Are there limits on what your diabetes program can plan? Yes or No.3.b)If no, hurray! You have the opportunity to plan, implement and evaluate the bestdiabetes program you can.c)If yes, you don’t need to worry, but you will need to be creative. Start by identifyingthe constraints. Document all the constraints by writing them down. As a team,discuss and decide what the focus of the diabetes program will be based on theconstraints.Recordkeepinga) Do you have someone on your team who likes details and is good at keeping trackof everything that the diabetes program does? Yes or No.b)If yes, you are lucky! Recruit them to the team if they are not already members.c)If no, you need to identify a person who has the training and skills to keep carefulrecords of the diabetes program. You may have to find someone willing to betrained. Even if it is low-tech methods like paper and pencil records, you mustcarefully document (write down!) everything you do. Find a person or two who hastraining and skills in organizational planning, numbers and spreadsheets, writingreports and skills in graphical software. Record their names, positions, and contactinformation by writing it down.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 13 -

Visual Planning Tool (or Road Map)Completing this tool during the training can help you plan where you want to go and how youwill get there. Print this blank form out now and complete it as you go through the training. Besure to print out several copies for each team member.Describe your resources.Resources What we invest, who weincludeActivities What we doDescribe your activities, goal and objectives.Goal Broad aim of diabetesprogramDescribe your goal.Objectives Specific, Measurable,Action, Realistic, Timebound (SMART)Describe your objectives.Products Numbers of things wedidDescribe products you will count.Results Changes as a result ofdiabetes programefforts, such aschanges in learning,skills behavior, policyDescribe results you will measure.ImpactConsequences of thediabetes programDescribe impacts you will document.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 14 -

Who to bring and what to pack! ResourcesResources are all the things that we invest a diabetes program. Resources can include things like time,staff, funding, equipment, and space. One important resource is the stakeholders. Stakeholders are thosepeople who have a strong interest in the diabetes program. Stakeholders can be those who:1. receive diabetes program services.2. make decisions about funding.3. plan and implement the diabetes program on a daily basis.It is critical to know what the stakeholders expect from the diabetes program and what they will do to helpthe. Stakeholders should be active participants in the diabetes program. You can help to ensure this byinvolving them early on.You can start the process of involving stakeholders by simply asking them: Why are you interested in the diabetes program?What do you want the diabetes program to accomplish?What resources (time, money, technical assistance) can you contribute?How will you help assure that the diabetes program is successful?Resources also include items like time, staff, funding, equipment and space. Think about each of theseand answer the following questions.StaffWho are some people that could or should be involved in your diabetes program? Be specific.Time What time commitment can these people make? Lack of time can be a serious limitation. Make surepeople have adequate time to commit to the diabetes program.Funding – staff, equipment, and space What kind of budget do you have? A common mistake is to want to do too much – more than thebudget will allow. Find out and create a realistic operating budget. What kind of equipment will you need? How does this fit with your budget? Do you have a designated location to conduct your activities? Consider collaborating with a group thatalready has a location. For example, the Wellness Center, a local gym, the elder center kitchen, and soon.Action! Go To: Resources Tool. Identify stakeholders and determine resources.Action! Go To: Visual Planning Tool (or Road Map). Complete the Resources row.Indian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 15 -

Resources ToolTake a few minutes and work together to determine ways to identify potential partners orstakeholders and determine the resources they may be able to contribute to the diabetesprogram. When you have completed this section be sure to add it to your visual planning tool.Diabetes ProgramStakeholdersTheir expectationsDiabetes programrecipients orparticipantscomplete this box now.Possible resources they cancontribute (time, money,equipment, space, expertise, etc)complete this box now.Decision makers –funding, staffing,space, etccomplete this box now.complete this box now.complete this box now.complete this box now.Diabetes programstaffIndian Health Services Division of Diabetes Treatment and PreventionProgram Planning and Evaluation WorkbookJanuary, 2011- 16 -

Picking the Best Route: AssessmentWhat is a Needs Assessment?A needs assessment is a way for health workers in the clinic and community to identify various healthissues. Once these health issues are identified, the diabetes team can work together to prioritize andaddress the community’s concerns. A needs assessment will help to strengthen the foundation of yourdiabetes program. An assessment is a bit like reviewing maps and guidebooks before deciding where to goand what to do on vacation.You can determine some of the health needs in your community by reviewing your latest IHS DiabetesCare and Outcomes Audit data. Available on line ex.cfm?module resourcesAuditFor example, you can use your IHS Diabetes Care and Outcomes Audit data to find out how manypeople have diabetes, what their ages are, what kind of treatment they are receiving, how manyhave received foot exams, eye exams, and laboratory tests. Using the audit data is a good way toidentify strengths and weakness of your clinical di

thinking about a trip, you cannot wait until the end of your trip to start the planning or evaluation process. Planning a trip starts the moment you get the idea of taking a trip. The planning and evaluation process must be started when the diabetes pr