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Audit of diabetes in general practice.
1Horfield Health Centre, Bristol.
BMJ (Clinical Research Ed.)
|February 23, 1991
Summary
This audit reveals that a Bristol general practice did not meet diabetes care standards, highlighting a need for improved processes. A simple audit method is proposed for ongoing quality improvement in diabetes management.
Area of Science:
- General Practice
- Diabetes Care Audit
Background:
- A Bristol general practice with 13,200 patients, established in 1983, had a diabetes care protocol.
- The practice has a high prevalence of diabetes (1.7%).
Purpose of the Study:
- To conduct the first audit cycle of diabetes care within a general practice.
- To develop a straightforward method for continuous audit cycle implementation.
Main Methods:
- Retrospective review of medical records for 223 known diabetic patients in 1990.
- Comparison of patient care processes and outcomes against predefined standards.
Main Results:
- The practice failed to meet several standards, including serum fructosamine levels (62% vs. 90% target) and blood glucose control (17-23% vs. 90% target).
- Newly diagnosed patients received insufficient referrals to dietitians (59%) and educational materials (28%) against a 100% standard.
Conclusions:
- The general practice requires improvements in the structure and execution of its systematic diabetes care process.
- A simplified audit focusing on a patient register, check-up attendance, and serum fructosamine levels is suggested for ongoing monitoring.