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Improving the quality of diabetes care

1 August 2001


Context Diabetes mellitus is a chronic illness that is becoming more prevalent. It requires continual medical care to prevent complications.

Objectives To document the current level of diabetes care and to prepare tools to help improve care at a family practice clinic.

Design The study occurred in two parts. Part I was a retrospective chart review examining diabetes care from 3/1100-3/1/01, for adult patients seen by the clinic. This care was compared to the American Diabetes Association Standards of Care 2000. In Part II, provider/patient guidelines and flow sheets were prepared.

Setting The study occurred at Maple Street Clinic, a family practice clinic, in Forest Grove Oregon

Patients 499 patients were billed for diabetes mellitus between 3/1199-31110 I. A random sample of I 00 charts of adult patients was taken from the 277 charts meeting the inclusion criteria.

Main Outcome Measures The percent of adult diabetes patients meeting the standards for BP, HbAlc, fasting lipid profile, VA, retinal, and foot exam was identified.

Results The percent of the sample meeting the following standards per year of study will be listed: 2 BP's, 86,96% (95% CI 6.21); 2 HbAlc's, 50% (95% CI 9.22); 1 VA, 48.91% (95% CI 9.22); 1 opt/ophth exam, 50% (95% CI 9.22); and 1 foot exam, 20.65% (95% CI 7.47). From 3/1199 to 3/1101 , 26.09% of patients, (95% CI 8.1), had 1 fasting lipid profile

Conclusions Preventive diabetes care at Maple Street Clinic needs improvement. Guidelines and flow sheets help improve care, which could decrease the risk of chronic complications of diabetes.


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