title: Implementation of a Diabetes Management Flow Sheet in a Long-Term Care Setting.
abstract: OBJECTIVE
  Physicians lack clear guidance about adaptation of clinical practice guidelines for elderly institutionalized patients with diabetes. In a large long-term care facility, a diabetes management flow sheet was trialed to determine which clinical parameters were found useful by clinicians in the management of diabetes in that setting.
  
  
  METHODS
  Clinical practice guidelines for diabetes management were reviewed with attending physicians. Diabetes management flow sheets were distributed for all patients coded as having diabetes on their most recent minimum data sets. After a period of 14 months, flow sheet completion rates were ascertained and physicians were surveyed regarding the utility of the flow sheet.
  
  
  RESULTS
  Initial flow sheet data were completed in full or in part for only 57% of the 121 study subjects; 39% of the subjects died within 14 months. Quarterly follow-up data were completed for 58% of the flow sheets.
  
  
  CONCLUSIONS
  The diabetes management flow sheet was not found to be useful by attending physicians as a chronic-disease management tool.
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: evelyn.williams@sunnybrook.ca.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Williams
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Curtis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008134:Long-Term Care / Q000639:trends; D008297:Male; D009735:Nursing Homes / Q000639:trends*; D017410:Practice Guidelines as Topic
keywords: diabetes management; long-term care; prise en charge du diabète; soins de longue durée