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Date of Graduation
Capstone Project (On-Campus Access Only)
Master of Science in Physician Assistant Studies
Robert P. Rosenow, PharmD, OD
Objective A study previous study perfonned at the Maple Street Clinic titled Improving the Quality of Diabetic Care, showed that DM care at the Maple Street Clinic did not meet Standards of Care 2000 identified by the American Diabetes Association. The objective at the Maple Street Clinic was to cost effectively implement a system of tools that will promote the change necessary to improve their quality of DM care.
Methods The studies pilot population consisted 64 DM patients. The status of six core measures, before and after the social intervention, was tracked to evaluate trends. Team members learned techniques while apart of the Oregon Diabetes Collaborative to effectively implement a system. These techniques were patterned after the Model for Improvement, and the PDSA cycles and themes. All the other providers DM patients at the Maple Street Clinic were also added over time to the database and evaluated in the same manner as the Maple Street Pilot population. Quasi-experimental research design was used to evaluate cause and affect relationship of psychological and physiological changes on outcome variables. A Times-Series Design was used to measure multiple measurements to determine trends in outcome variables.
Results The outcome measures of the percent of patients with a HbA1c test result of < 8 and the percent of patients with a LDL test result of < 130 did not show positive trend lines but were considered to be long term measures, and therefore given less weight in the determination of the studies success. On the other hand, retinal exams, foot checks, and the number of patients ever receiving an HbA1c test or an LDL test all showed positive trend lines.
Conclusions The study concluded that the implementation of the chronic care model at the Maple Street Clinic for their diabetic patient population was an overwhelming success. Positive trend lines and improved outcome measures were not only were shown in the Maple Street Pilot Population, but also all of the other provider DM patient populations.
Morehouse, Samuel H., "The Maple Street Initiative: Implementation of a diabetic chronic care model to improve the standard of patient care" (2002). School of Physician Assistant Studies. 361.