Improving Diabetes Care in the Primary Care Setting

Priscilla Holtzclaw
Trident Family Medicine
Charleston SC

Introduction: Diabetes Mellitus is a common disease managed in primary care. With multiple physicians in a residency practice, it can be difficult to provide systematic care. With the electronic medical record (EMR), it was found that our our measurement rate for hemoglobin A1C was 30%, and that only 20% of patients met the hemoglobin A1C goal. A quality improvement project was undertaken to improve our care.

Method: Diabetic patients were identified through the EMR and each chart was marked to highlight the diabetes diagnosis. Nurses were provided with standing orders for diabetic labs. Once point-of-care testing equipment is available, results of hemoglobin A1C and cholesterol testing will be immediately available for the physician during that day’s visit.

Measurement: Quarterly reports from the EMR showing diabetic testing rates will be used to evaluate the efficacy of the standing lab orders. Similarly, lab results detailing the number of diabetic patients meeting ADA goals will allow evaluation of the quality improvement intervention.

Conclusion: The health benefits from meeting goals established for diabetes patients is well documented. Establishing a systematic care system allows a primary care provider to better meet the goals of these patients.