+ Effects of Quality Improvement Strategies on Diabetes Care Presented by: Cali Trepp, Caitlin Dowhie, and Rosa Sanchez

+ Current Care of Diabetes What percentage of Diabetic patients are hypertensive? It is estimated that more than one-third of patients are hypertensive (Shojania et al., 2004). What percentage of Diabetic patients have elevated LDL-cholesterol levels? More than one-half of patients have elevated LDL-cholesterol levels (Shojania et al., 2004). How many Diabetic patients receive recommended Hba1c measurements? Only 28% of diabetics receive the recommended HbA 1c measurements (Shojania et al., 2004). Thus, many patients are not receiving sufficient care despite constant treatment advances. Based on these numbers, what does that tell us?

+ Quality Gaps in Care Prevention screening Treatment processes Improvements in these areas decrease morbidity and mortality (Shojania et al., 2004).

+ Our Study Analyzes the effects of quality improvement strategies on diabetes care to address quality gaps. Literature review

+ Scope Focused on adults with type 2 Diabetes Did not focus on children because of a higher prevalence of type 1 Diabetes Did not include gestational Diabetes

+ Inclusion -What research was included? evaluate an intervention meeting the authors' definition for quality improvement use an experimental or quasi-experimental design report at least one measure of disease control, provider adherence, or patient compliance

+ Interventions Utilized Provider reminders Facilitated relay of clinical data to provider Audit and feedback Provider education Patient education Promotion of self-management Patient reminders Organizational change Financial, regulatory, or legislative incentives

+ Outcomes Researchers targeted three broad categories of study outcomes when selecting literature: measures of disease control measures of provider adherence to recommended care patient adherence to prescribed medications and self-care recommendations

+ How can we measure these outcomes? Reduction of HbA1 c, systolic blood pressure, and diastolic blood pressure Changes in adherence were reported using a percentage of patients in each group who received care before and after intervention

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+ Let’s see what you remember!

+ Why is the use of QI strategies important in Diabetes care? Decrease mortality and morbidity Improve treatment and screening processes

+ What were two QI strategies this study utilized? Provider reminders, facilitated relay of clinical data to providers, audit and feedback, provider education, patient education, promotion of self-management, patient reminders, organizational change, and financial, regulatory, or legislative incentives

+ Name one outcome the study analyzed? (What changes were they observing? measures of disease control measures of provider adherence to recommended care patient adherence to prescribed medications and self-care recommendations