Pre-Visit Planning for Three-Month Diabetes Follow-Up Visits
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Date
2018-04-23
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Authors
Lackey, Kim
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Abstract
A primary care practice site in western North Carolina manages approximately 200 patients with diabetes per month. There were no pre-planned, tools in place to appropriately monitor, educate, and manage the Diabetes Mellitus (DM) population. A pre-planned standardized process was implemented to gauge its effectiveness using the American Diabetes Association’s (ADA) clinical standards and national diabetic guidelines as a template. A methodology was used to develop a packet for providers and ancillary staff. The packet included tools for providers to organize patient information, devise treatment plans, establish goals of care, and monitor patient preparation. The intention was to improve patient adherence to blood glucose logs and encourage self-management practices. Three educational sessions were held to described how to use the packet within the process change. Guiding frameworks were Nola Pender’s Health Promotion Model (HPM) and E.H. Wagner’s Chronic Care Model (CCM). The Plan-Do-Study-Act (PDSA) tool was utilized weekly during the three-month implementation phase to monitor progress toward completion of project goals. The new practice change decreased behavioral and environmental barriers. There was a decrease in missed appointments from 17% to zero percent, and an increase in patient adherence from 11% to 23%. The practice changes also uncovered a 34% staff compliance rate, which was attributed to time management issues, individual resistance to change, and staffing fluctuations.
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Lackey, K. (2018). Pre-visit planning for three-month diabetes follow-up visits. East Carolina University, Greenville, North Carolina.