Outcomes management of an ambulatory clinic system population: experience with patients with diabetes.
OBJECTIVE
North Mississippi Medical Center (NMMC) applied well-established in-patient outcomes management techniques to patients in its ambulatory care clinics. Diabetes was targeted for the initial outcomes management project because screening and treatment guidelines are clear and non-controversial.


METHODS
Eleven providers in five clinics were initial participants in the pilot program that recorded annual screening of HgbA1c, lipids, microalbumin, foot exams, and eye exams. Physicians were provided with individualized performance profiles along with diabetes management education. The pilot data were well received, and the program was expanded to 67 primary providers in 23 clinics in northeastern Mississippi and northwestern Alabama.


RESULTS
A 12-month review of annual screening demonstrated statistically significant improvement in HgbA1c screening from 83% to 97% (p < or = 0.001); microalbumin screening increased from 12% to 33% (p < or = 0.001); and foot exams increased from a baseline of 24% to 31% (p < or = 0.001).


CONCLUSIONS
Providing individualized data on ambulatory care management engaged physicians in improving annual diabetes screening.
North Mississippi Medical Center, Tupelo, USA.
Dana
D
Walker
Ken
K
Harvey
D019985:Benchmarking; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006442:Glycated Hemoglobin / Q000032:analysis; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008922:Mississippi; D009096:Multi-Institutional Systems; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D011159:Population Surveillance; D016730:Program Development
D006442:Glycated Hemoglobin