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Open Access Exploring point-of-care transformation in diabetic care: A quality improvement approach

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Objective: This quality improvement project evaluated the impact of a point-of-care (POC) HbA1c stat lab intervention and a nurse-assisted expanded visit implemented among patients with uncontrolled type 2 diabetes (T2D) at a community health center in Houston, TX.

Methods: This was a before-and-after POC intervention among adult patients who received primary care services between 1 July 2014 and 31 December 2014 (baseline visit) and who had at least one 3-month follow-up visit.

Results: Three hundred eighty-seven patients were included in the study. The majority were <60 years of age (72.1%), female (60.5%), and Hispanic (63%), followed by black (16.5%) and Asian (11.1%). Almost 87% of the patients had uncontrolled T2D (HbA1c >9%) at baseline, with the highest average levels among Hispanic (10.9%) and black (10.7%) patients. There was a significant difference in the HbA1c level before (mean=10.65, SD=1.9291) and after (mean=9.25, SD=1.8187) intervention. The absolute reduction in the level of HbA1c was 1.4% (t=12.834, p<0.001), corresponding to a 13% overall percentage decrease from baseline.

Conclusion: There is a distinct advantage in using a stat HbA1c lab when combined with shared POC visits to assist patients with uncontrolled T2D in lowering the HbA1c, improving self-management, and reducing long-term costs.

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Keywords: Diabetes; point of care; stat HbA1c

Document Type: Research Article

Publication date: 2015-06-01

More about this publication?
  • Family Medicine and Community Health (FMCH) is an open-access journal focusing on subjects that are common and relevant to family medicine/general practice and community health. The journal publishes relevant content across disciplines such as epidemiology, public health, social and preventive medicine, research and evidence based medicine, community health service, patient education and health promotion and health ethics. The journal has a specific focus on the management of chronic illness particularly diabetes, ischaemic heart disease, chronic heart failure, hypertension, bronchial asthma, chronic obstructive airways disease and common mental illness. FMCH is published by Compuscript http://www.compuscript.com on behalf of the Chinese General Practice Press http://www.chinagp.net.

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