Note about support staff development: It is recommended that all support staff working within a Joslin Affiliate attend a basic diabetes education class so they can have an understanding of what patients experience and also be able to have an understanding about diabetes. Focus on addressing misconceptions and common concerns they may hear from patients. It may also be helpful to pair an educator with one of the support staff team members for occasional observation and mentoring. This orientation program does not present diabetes basics, but focuses more on what is unique about Joslin. Slides 1 – 21 is the basic Joslin overview. Slides 21 – 28 includes messages more on customer service essentials. Both parts can be done together or either section can be done on its own. Please feel free to call your site coordinator to review the slides and key messages as you prepare to use these with your support staff. Your Part in the Success of the Joslin Diabetes Center: Orientation for Support Staff

Goals of this Presentation Describe Joslin history and mission Explain your hospital’s relationship to Joslin in Boston and the other Joslin Diabetes Centers List the Joslin Diabetes Center services for your patients Identify what you can do to make a good impression on patients Discuss importance of having patients use the whole team Confidential

Joslin Diabetes Center Mission: To improve the lives of people with diabetes and its complications through innovative care, education, and research that will lead to prevention and cure of the disease. Confidential

Joslin Diabetes Center Experience and History World-recognized leader for over 100 years Harvard Medical School affiliate Research and Discovery Reported relationship between tight control and complications Developed laser for diabetic eye disease Identified causes for Type 1 diabetes Developed techniques for improving pregnancy outcomes Care and Treatment Cared for more than 225,000 people with diabetes in Boston Pioneered team approach to diabetes management Education and Outreach Award winning publications Leading provider of Continuing Medical Education 25 Affiliate locations nationwide (and international) Confidential

The world relies on Joslin Joslin’s global impact magnifies every investment and every breakthrough –putting Joslin in the best position to find a cure Largest institution in the world devoted exclusively to diabetes research, care and education More than 40,000 patients cared for by the Joslin Vision Network More than 100,000 patients seen each year at 27+ Joslin Affiliated Centers Affiliated with Harvard Medical School Joslin Diabetes Center World’s largest team of board certified physicians treating diabetes Highest patient population on insulin pumps in the world Sets the standard of care and education with 250,000+ patients treated Database of medical data stretching back decades Best record for saving kidneys, legs and eyesight potentially lost to diabetes Highest concentration of diabetes educators in the world Confidential

Strategic Partnerships The public sees Joslin’s name in many places! Walgreens – many diabetes resources Calorie King – Joslin provided diabetes content Time magazine – an annual diabetes insert Confidential

Elliott P. Joslin, MD 1898 – 1962 First doctor in US to specialize in diabtes Founder of the Joslin Clinic, worlds first diabetes care facility Developed role of the diabetes educator Published many books 10 medical textbooks 10 manuals “for the mutual use of doctor and patient” Confidential

The diabetic who knows the most, lives the longest. “The number of cases is so great… that their care must rest in the hands of the general practitioner. It is ridiculous to expect that the treatment of (all) diabetics should be under the supervision of a specialist.” -E.P. Joslin, MD The diabetic who knows the most, lives the longest. Confidential

Goals of Affiliated Programs Locate near the people we serve Deliver high quality care cost effectively Share ideas with centers around the world Bring more people to our hospital Team up with the world’s leader in diabetes care, education and research 15

Key 17 40 34 3 3 Confidential Skilled Nursing Facilities International 1. University of California Irvine Medical Center — Irvine, CA 2. Lawrence and Memorial Hospital — Mystic, CT Lawrence and Memorial Hospital — New London, CT Lawrence and Memorial Hospital — Old Saybrook, CT 3. The Hospital of Central Connecticut — Farmington, CT The Hospital of Central Connecticut — New Britain, CT 4. Mercy Medical Center — Cedar Rapids, IA 5. OSF HealthCare — Bloomington, IL OSF HealthCare — Peoria, IL 6. St. Mary’s Medical Center — Evansville, IN 7. Floyd Memorial Hospital & Health Services—New Albany, IN 8. Joslin Clinic — Boston, MA Joslin Clinic — Needham, MA 9. Doctor’s Community Hospital — Lanham, MD 10. Providence Hospital — Novi, MI Providence Hospital — Southfield, MI 11. Southern NH Medical Center — Nashua, NH 12. Frisbie Memorial Hospital — Rochester, NH 13. AtlantiCare Medical Center — Atlantic City, NJ AtlantiCare Medical Center – Hammonton, NJ 14. Upstate Medical University Hospital — Syracuse, NY 15. St. Vincent Charity Medical Center — Cleveland, OH 16. Southview Hospital — Dayton, OH 17. Forbes Regional Medical Center — Monroeville, PA Alle-Kiski Medical Center — Natrona Heights, PA Western Pennsylvania Hospital — Pittsburgh, PA 18. Temple University Hospital — Philadelphia, PA 19. Southeast Texas Medical Associates — Beaumont, TX 20. Cypress Fairbanks Medical Center Hospital — Houston, TX 21. St. Mary’s Medical Center — Huntington, WV 22. Brookwood Medical Center — Birmingham, AL 23. Hallmark Health System – Melrose, MA 24. Deborah Heart & Lung Center – Browns Mills, NJ 25. Wake Forest Baptist Health – Wake Forest, NC Skilled Nursing Facilities 26. Newington Health Care Center — Newington, CT 27. Concord Healthcare Center — Concord, MA 28. The Hurlbut — Rochester, NY International 29. Chaleur Regional Medical Center — Bathurst, NB, Canada 30. Dasman Institute — Kuwait 31. Agada Healthcare – Chennai, India 12 11 14 27 23 8 28 2 3 26 17 10 15 17 18 24 4 13 40 16 5 7 9 34 21 6 1 3 25 3 22 20 19 29 30 February 18, 2011 Confidential

Joslin Affiliates Receive… Operating Manuals Joslin protocols/guidelines Clinical, operational, and marketing support Staff training/education Patient education materials Assistance with ADA program and provider recognition Outcomes tracking and benchmarking Monthly operating report Annual meeting/ networking Use of Joslin name/reputation Exclusive territory Assistance in recruitment of endocrinologist(s) Access to Joslin’s web-based education programs Close connections with Joslin! 19

Everyone is essential to the success of the program! The Joslin Team Patient Endocrinologist Center Administrator Nurse Educator (CDE) Dietitian Educator (CDE) Nurse Practitioner Receptionist Medical Assistant Billing …and more! Everyone is essential to the success of the program! Confidential

Being Part of a Network Joslin Diabetes Center in Boston communicates with you: through the monthly Affiliate Newsletter via email and phone through conference calls on-site visits a designated Affiliate site coordinator Joslin Diabetes Center in Boston is: a resource for your program a link to other experts in the network responsible for new program development interested in your feedback Confidential

Joslin Resources Publications Website – www.joslin.org 20% discount for Affiliates Website – www.joslin.org Special password Discussion Boards for patients Joslin Store Continuing Medical Education programs Confidential

Your job is to explain your Joslin Diabetes Center’s services to patients and callers. Confidential

Important Joslin Education Themes The educator works to convey the following messages to all patients: Joslin CHECK Points: Confidence Hope Empowerment Clarity Knowledge Confidential

Joslin Assumptions The patient is in charge of his/her diabetes Education is provided so patients can make informed decisions and solve day-to-day problems The healthcare provider cannot make a patient do something she/he is not willing or ready to do Aim to discuss “real” diabetes – not the academic subject Confidential

The Educator’s Role – Dietitian or Nurse Help patients: Understand their disease Solve problems Improve food choices Check blood glucose and take action when the glucose is not in target Prepare for sick days Check their feet and report problems Take control of their diabetes Avoid complications Prepare for and manage diabetes in pregnancy Confidential

Joslin Assumptions Education is ongoing and requires continuous evaluation of progress towards goal Behavioral outcomes are the unique domain of educators Family members are an essential part of the education process The patient decides what roles the family members should play Confidential

You are the First Impression of Joslin Express your enthusiasm for what Joslin can do for patients Encourage patients to use the whole team Know your program and be able to explain the services Stress the importance of patients keeping appointments When making reminder phone calls, ask patients if they intend to keep the appointment As the patient is leaving ask, “Is there anything else we can do for you today?” Confidential

100 of the Joslin 50 Year Medalists It’s all about the person with diabetes! 100 of the Joslin 50 Year Medalists Confidential

The E’s (Ease) of Customer Service

10 E-ssentials Everyone’s name used (personal) Etiquette (courteous a’ la Ritz) Exact (on-time / correct) Exceptional Educational Material (Wow!) Exceed Expectations (offer an Extra something) Easy, Effortless Systems (anticipate needs) Entertaining (edu-tainment) Employee Enjoyment (happy, rewarded, smiling!) Engage all Senses (enhancing the experience) Educate (staff and patients alike) Confidential

How YOU doin’? Walk in the customers shoes Assess each E-ssential Identify area(s) for improvement Make a plan Implement Evaluate 1 2 3 4 5 6 7 8 9 10 Confidential

What do you say when a patient says this? “I’d like to make an appointment to see just the doctor. I don’t need to see an educator” “I know what to eat. I don’t need a dietitian” “What’s different about Joslin?” How do you talk patients into seeing an educator? Discuss with your team. Confidential

When Things Go Wrong… Communicate with patients – do not ignore them Acknowledge the problem Apologize for the inconvenience Explain what will be done, is being done or was done to fix the problem Inform patients about delays Tell patients you are running behind Explain the reason Call patients if necessary Offer them the opportunity to reschedule Offer a service recovery gift; discuss options with your team Confidential

Did this program meet the goals? Do you understand: Joslin history and mission? your hospital’s relationship to Joslin in Boston and the other Joslin Diabetes Centers? what you can do to make a good impression on patients? Can you: Explain your Joslin Diabetes Center services to patients? Talk patients into using the whole team? Confidential

You are the face and voice of the Joslin Diabetes Center, world-recognized leader! Makes us proud! Confidential