title: Diabetes quality of care in academic endocrinology practice: a descriptive study.
abstract: OBJECTIVE
  To describe the quality of diabetes care delivered by academic endocrinologists practicing at 4 teaching hospitals affiliated with a single medical school.
  
  
  METHODS
  Up to 30 patients who first saw an endocrinologist for an ambulatory consultation for diabetes between January 2004 and December 2005 were randomly selected for chart review. Process and intermediate measures of quality of care were abstracted.
  
  
  RESULTS
  There were 417 patient charts available for analysis. Quality of care was generally high, with 61% of patients achieving a glycated hemoglobin of ≤7.0%, 77% achieving blood pressure ≤130/80 mm Hg and 73% achieving a low-density lipoprotein cholesterol level of ≤2.5 mmol/L. More than 80% of patients had had eye examinations, microalbuminuria screening and foot examinations. There were no significant differences in quality between hospitals.
  
  
  CONCLUSIONS
  The quality of diabetes care delivered by academic endocrinologists in this setting was high and approached the "ideal" levels of care recommended by practice guidelines. Compared to past studies in both the primary and specialist care settings, the results show that high-quality care can be delivered in routine academic clinical practice without having previously instituted a specific quality improvement program.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: baiju.shah@ices.on.ca.
authors.forename: Baiju R
authors.initials: BR
authors.lastname: Shah
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: James
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Lawton
authors.affiliation: St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Tess
authors.initials: T
authors.lastname: Montada-Atin
authors.affiliation: University Health Network, Toronto, Ontario, Canada.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sigmond
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Cauch-Dudek
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Booth
keywords: academic practice; endocrinologie; endocrinology practice; hopitaux d'enseignement; qualite des soins; quality of care