Introduction: Studies have shown significant gaps in diabetic preventative care in resident clinics compared to private clinics of practicing physicians. In our medicine-pediatrics resident clinic at Beaumont Hospital, diabetic point of care resources are largely underutilized. We aim to improve the care of patients with diabetes by increasing resident awareness of point of care A1c and retina scan resources. Methods: A team of residents, attendings, and nurses was created. Baseline data looking at use of point of care resources, specifically the number of orders placed in electronic medical record for A1c and retina scan tests, was obtained. A root cause analysis discovered several contributing factors leading to inefficient diabetic patient care. Key factors included lack of resident awareness on available point of care resources, insufficient equipment, and lack of trained nurses. We completed two Plan Do Study Act (PDSA) cycles to increase resident awareness of clinic resources. The first PDSA cycle involved an educational session for residents, explaining how to order the point of care resources. Six weeks later, a second PDSA cycle involved an informative poster (detailing the resource ordering process) placed in the clinic. Results: Over 6 months, at baseline, 5 patients had retina screening and 2 patients had point of care A1c testing completed out of 62 diabetic patients. After first intervention, 8 patients had A1c testing and 13 patients had retina screening completed, an increase of 300% and 160% respectively from baseline. After second intervention, 22 patients had retina screening completed, an increase of 340% from baseline while there was no change in A1c testing. Conclusion: Increased resident education and awareness led to improved use of point of care diabetic resources. The ability to provide point of care A1c and retina scan results allows for immediate management interventions, earlier detection of complications, and overall improved care.
Chopra K, Owusu-Asare C, Espinosa A, Halalau A. Diabetic preventative care in a resident clinic: a quality improvement study. Abstract presented at: American College of Physicians-Michigan, 2021 Michigan Chapter Virtual Meeting. 2021 Oct 14-17;Virtual.