Physician documentation of diabetes care: use of a diabetes flow sheet and patient education clinic.
We assessed two interventions designed to improve the care of patients with diabetes mellitus by documenting the complications of their disease. These were a flow sheet, included with outpatient medical records, and a weekly patient education clinic, in which a nurse educator provided individualized instruction to patients with diabetes. Physician compliance with recommendations of the National Diabetes Advisory Board for diabetes care was measured before (n = 45) and after (n = 158) these interventions. The numbers of referrals to ophthalmologists increased from 22% to 46%, urinalyses increased from 58% to 77%, and lower extremity examinations increased from 36% to 61%. Nutrition education documentation increased from 51% to 69%, and diabetes education documentation increased from 31% to 61%. These results suggest that a significant improvement in physicians' documentation of care of patients with diabetes can be achieved by using a flow sheet and a diabetes patient education clinic.
Hempel
R J
RJ
Tallahassee Memorial Regional Medical Center Family Practice Residency Program, Fla.
D000328:Adult; D000554:Ambulatory Care Facilities; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy / Q000652:urine; D003930:Diabetic Retinopathy / Q000628:therapy / Q000652:urine; D005069:Evaluation Studies as Topic; D005194:Family Practice / Q000592:standards*; D005260:Female; D005534:Foot Diseases / Q000209:etiology / Q000628:therapy / Q000652:urine; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000592:standards*; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009885:Ophthalmology; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D012017:Referral and Consultation; D012189:Retrospective Studies