title: Diabetes care may be improved with Steno Quality Assurance Tool--a self-assessment tool in diabetes management.
abstract: To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software.
  
  
  METHODS
  Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality Assurance Tool (SQAT). Data was entered for an initial 3 months period. Subsequently data were analyzed by the users, who designed plans to improve indicator status and set goals for the upcoming period. A second data entry period followed after 7-9 months.
  
  
  RESULTS
  QA data was analyzed from 4487 T2DM patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p=0.007), foot examination (80-94%) (p=0.02), HbA1c investigation (59-77%) (p=0.006), and urine albumin excretion investigation (72-87%) (p=0.006). Outcome parameters also improved significantly: mean (SD) fasting and post prandial BG reduced from 144(16) to 132(16)mg/dl (p=0.02) and 212(24)-195(29)mg/dl (p=0.03), respectively. Systolic BP reduced from 139(6) to 133(4) (p=0.0008)mmHg and diastolic BP from 83(3) to 81(3)mmHg (p=0.002).
  
  
  CONCLUSIONS
  Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators.
authors.affiliation: Steno Diabetes Center, Niels Steensensvej 2-4, DK 2820 Gentofte, Denmark. Electronic address: ulbj@steno.dk.
authors.forename: Ulla
authors.initials: U
authors.lastname: Bjerre-Christensen
authors.affiliation: Steno Diabetes Center, Niels Steensensvej 2-4, DK 2820 Gentofte, Denmark.
authors.forename: Annemette Anker
authors.initials: AA
authors.lastname: Nielsen
authors.affiliation: Steno Diabetes Center, Niels Steensensvej 2-4, DK 2820 Gentofte, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Binder
authors.affiliation: Novo Nordisk A/S, Vandtårnsvej 114, DK 2860 Søborg, Denmark.
authors.forename: Jes B
authors.initials: JB
authors.lastname: Hansen
authors.affiliation: Endokrinologisk afdeling, University Hospital Herlev, Herlev Ringvej 75, DK 2730 Herlev Denmark.
authors.forename: Ebbe
authors.initials: E
authors.lastname: Eldrup
mesh_terms: D003920:Diabetes Mellitus / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000592:standards*; D011787:Quality of Health Care; D012648:Self Care / Q000379:methods*; D012647:Self-Assessment; D012984:Software
keywords: Clinical quality; Diabetes; Self-assessment