Improving Patient-Centered Screening for Diabetes and Follow-Up in a Rural Primary Care Clinic.

Abstract

Diabetes is a significant health problem that has reached pandemic proportions and affects 830 million people worldwide. In 2022, the direct and indirect costs associated with diabetes in the United States were $412.9 billion. On average, people with diagnosed diabetes have medical expenditures 2.6 times higher than would be expected in those without diabetes. A chart audit at a rural primary care clinic revealed that only 44% of the population with diabetes had proper care at the time of diagnosis. This quality initiative aimed to improve patient-centered diabetes screening and follow-up in an 8-week period to 80%. A rapid Plan-Do-Study-Act process approach was implemented for the initiative in four 2-week cycles over 8 weeks. Results from each cycle dictated the test of change for the subsequent cycle. A diabetes screening tool and a patient engagement toolkit were adapted from updated, evidence-based guidelines to influence adequate and appropriate screening while actively engaging a population of patients with diabetes. Over the 8-week period, 128 charts were screened, and the rate of patient-centered diabetes follow-up improved from 44% to 83%. In that same period, 201 patients were screened, and the rate of diabetes screening improved by 50%. This initiative improved patient-centered diabetes screening and follow-up by implementing evidence-based screening tools and adapted engagement toolkits that originated from the American Diabetes Association. Further research should explore how early intervention and effective management of prediabetes and diabetes impact the development of comorbidities associated with the disease.