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Show Diabetic Bundle Implementation to Improve Clinical Quality Measures: A Quality Improvement Project Frances M. Johnson, Katherine M. Hastings, Elizabeth M. Bald, Dominik Ose, and Julie P. Gee Key Findings: This Quality Improvement (QI) Project aimed to improve clinical quality measures by implementing the use of the dotphrase, ‘.diabeticbundle’, in the Electronic Health Record (EHR) clinic visit notes for adults ages 18-65 who have Type 2 Diabetes Mellitus (T2DM). We monitored frequency of use of the dotphrase and assessed Healthcare Professional’s (HCP) usability, feasibility, and satisfaction with dotphrase use. Data was assessed and statistical inferences were made based on pre- and post-intervention surveys along with EHR data showing dotphrase use and changes in clinical quality measures. Background • In the US, there are approximately 34.2 million adults over 18years of age who have diabetes1. • The US spends about $245 billion each year in direct and indirect costs of care related to diabetes1. • In Utah, over 180,000 adults over the age of 20-years have T2DM2. • With the onset of the Covid-19 pandemic, rates of T2DM increased, and care delivery practices had to change to properly treat and support individuals in timely management of their diabetes screening exams. Results Clinical Quality Measures 475 42.00% 470 41.00% • A statistically significant increase in use (p>0.001) of the dotphrase post-intervention was demonstrated. 465 40.00% • Improvement in diabetic bundle clinical quality measures. 460 39.00% • Feasibility: 11/12 found the dotphrase to be easy to use. 455 38.00% 450 37.00% 445 36.00% Sep-21 Oct-21 Nov-21 Patients Dec-21 % controlled • Usability: 11/12 felt like using the dotphrase helped to improve patient care and clinical quality measures. • Satisfaction: 9/12 plan to continue using the dotphrase longterm. *Controlled: Up to date on Diabetic Bundle measures. Methods • QI project implemented at the Madsen Family Health Center at the University of Utah in Salt Lake City, UT. • Assessed provider’s current clinical practices for diabetes screening examinations. Elements of the Diabetic Bundle Clinical Quality Measures: Hemoglobin A1c, Blood Pressure, Urine Microalbumin, & Statin Medication Use. Dotphrase Use Pre/Post-Intervention 100% 90% 80% • Developed educational presentation regarding QI project and use of dotphrase, ‘.diabeticbundle’. 70% 60% • Implemented use of dotphrase for persons diagnosed with T2DM (ages 18-65). • Evaluated changes in HCP’s diabetes screening practices along with feasibility, usability, and satisfaction with dotphrase use. Evaluated changes in clinical quality measures. 10% • Post-intervention, the dotphrase was used more frequently, and it became a part of some HCP’s practice habits. • Using the dotphrase improved diabetic bundle clinical quality measures, including screening rates for hemoglobin A1c, blood pressure, statin medication use, and urine microalbumin. • It can be reasonably presumed that long-term use of the dotphrase will increase patient screening rates which in turn, may improve patient health outcomes related to T2DM. 50% 40% Conclusions 30% 20% 0% Pre Post No Yes *Yes: Has used the dotphrase, No: Has not used the dotphrase References: 1. Centers for Disease Control and Prevention. (2020, June 24). Prevalence of Both Diagnosed and Undiagnosed Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html. 2. Utah Department of Health. (2021, January 19). Health Indicator Report of Diabetes Prevalence. Public Health Indicator Based Information System (IBIS). https://ibis.health.utah.gov/ibisph-view/indicator/view/DiabPrev.html. COLLEGE OF NURSING |
