Improving Care in a Resident Practice for Patients With Diabetes
| Autor: | James K. Salem, Hope Torregosa-Arcay, Lynn Clough, Ronald R. Jones, David B. Sweet, Sana Hasan |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Chronic care
medicine.medical_specialty business.industry Medical record Retrospective cohort study General Medicine medicine.disease Bioinformatics chemistry.chemical_compound Blood pressure chemistry Diabetes mellitus Emergency medicine medicine Educational Innovation Glycated hemoglobin business Glycemic |
| Zdroj: | Journal of Graduate Medical Education. 3:196-202 |
| ISSN: | 1949-8357 1949-8349 |
| Popis: | Background Curricular redesign and introduction of the Chronic Care Model in our residency clinic during 2005–2007 achieved limited success in glycemic (glycated hemoglobin level [A1c]), lipid (low-density lipoprotein fraction [LDL]), and blood pressure (BP) control for patients with diabetes. Intervention Beginning in January 2008, ancillary staff performed previsit, protocol-driven reviews of medical records of patients with diabetes to identify those not at A1c, LDL, and BP goals; inserted electronic prompts into the records regarding deficiencies; and obtained samples for A1c or lipid panel when needed. Faculty feedback regarding resident-specific panel reviews was added in May 2008, and point-of-care A1c testing was implemented in February 2009. Methods We conducted a 2-year retrospective study of all patients at our facility with diabetes mellitus, who had at least 1 visit during January to June 2008 (baseline) and 1 visit during July to December 2009 (follow-up). Measures included the most current A1c, LDL, and BP results. Paired outcome results were compared using the McNemar χ2 test. Results A total of 522 patients with diabetes mellitus were seen during the baseline and follow-up periods, and 456 patients (87.4%) had paired A1c results, with A1c Conclusion The interventions resulted in statistically significant improvements in the proportion of patients with diabetes who attained goal for A1c, LDL, and BP levels. Our redesign elements may be useful in enhancing resident education and in improving patient care. |
| Databáze: | OpenAIRE |
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