Effectiveness of a Provider Feedback System on Diabetes Outcomes in a Residency Practice At the end of this talk, the resident will be able to: Recognize guidelines for administration of Td, pneumovax and flu vaccine. Describe screening guidelines for Type 2 DM. Discuss screening guidelines for osteoporosis and hypercholesterolemia. Describe screening (and discontinuation of screening) guidelines for colorectal, breast, cervical and ovarian cancer. Discuss the harmful effects of smoking and screen patients for tobacco use. Background Goal: To examine an innovative chronic disease management strategy to improve diabetic patient outcomes with Family Medicine residents Objective: To evaluate the effectiveness of resident-specific report cards to improve compliance with nationally defined patient management targets for diabetes Rationale: Residents will be able to: Locate and summarize medical guidelines on chronic diseases Identify practice management strategies Demonstrate team building behaviors Utilize fully the electronic medical record system Apply Continuous Quality Improvement methods Methods Cohort study with 30 Family Medicine residents Scorecards are based on ADA Clinical Guidelines 6-month follow up data is pending Results A1c Testing: 91% of patients received an A1c test in the last 6 mos Most patients are not at goal of < 7% Blood Pressure: 48% have BP<130/80 Lipid Testing and Control: 40% have LDL-C<100 Nephropathy Screening: 32% had Microalb/CR within last year Neuropathy Screening: 33% had monofilamet test within last year Retinopathy Screening: 11% had documented eye exam within year Pre-Scorecard February 2006 2005 – 2006 Schedule Prevention Congestive Heart Failure Asthma ADHD Lipids Diabetes Hypertension Obesity 2006 – 2007 Schedule Prevention Depression Lipids Diabetes Tobacco Abuse Childhood Immunization HIV Osteoporosis Didactic Afternoon Grand Rounds Standards of Care Blood Glucose Monitors Screening for DM Neuropathy Scorecard Review Conclusions Didactic afternoon in conjunction with review of selected clinical performance measures increases resident awareness of clinical outcomes Diabetes will continued to be studied every year providing residents with results every six months A clinical intervention designed to improve results will be selected this year and implemented through the Quality Improvement Committee Results are based on all patients seen in the department by physician providers with a diagnosis code of 250 age 18 and older over the last two years