title: A system-based intervention to improve postpartum diabetes screening among women with gestational diabetes.
abstract: OBJECTIVE
  We sought to determine whether our process improvement program led to increased postpartum diabetes screening rates among women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  In early 2009, we conducted obstetrics department staff education sessions, revised GDM patient care protocols, and developed an electronic system to trigger reminder calls to patients who had not completed diabetes mellitus screening by 3 months postpartum. We then evaluated the rates of postpartum glucose test order entry and completion for women with GDM delivering from July 2009 through June 2010 (n = 179) and July 2007 through June 2008 (n = 200).
  
  
  RESULTS
  After the program's implementation, the proportion of women receiving an order for a postpartum glucose test within 3 months of delivery increased from 77.5-88.8% (P = .004), and test completion increased from 59.5-71.5% (hazard ratio, 1.37; 95% confidence interval, 1.07-1.75).
  
  
  CONCLUSIONS
  Rates of postpartum diabetes testing can be improved with system changes and reminders.
authors.affiliation: Center for Health Research, Northwest/Hawaii/Southeast, Kaiser Permanente Northwest, Portland, OR 97227-1110, USA. Kimberly.k.vesco@kpchr.org
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dietz
authors.forename: Joanna
authors.initials: J
authors.lastname: Bulkley
authors.forename: F Carol
authors.initials: FC
authors.lastname: Bruce
authors.forename: William M
authors.initials: WM
authors.lastname: Callaghan
authors.forename: Lucinda
authors.initials: L
authors.lastname: England
authors.forename: Terry
authors.initials: T
authors.lastname: Kimes
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Bachman
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Hartinger
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy