Improving Timely Annual Ocular Examinations for Patients With Diabetes Mellitus in a Primary Care Office

A common complication of diabetes mellitus (DM) is diabetic retinopathy (DR).

An audit in a primary care office found that fewer than 50% of patients with DM received an annual ocular examination. The aim of this project was to increase timely annual ocular examinations among patients with type 2 DM to 85% within 90 days.

The model for improvement with 4 Plan-Do-Study-Act (PDSA) cycles was implemented in a rapid cycle format as well as changes in an electronic medical record (EMR) checklist and referral processes.

Interventions included team huddles and trainings, the Association of Diabetes Care and Education Specialists checklist with additional information about DR, an EMR checklist, and a logbook referral tracking process changes.

Of the patients referred during the project, 87% completed the ocular appointment, and the rate for patients with DM having annual ocular examinations increased from 48% to 86% meeting the current guideline of the American Diabetes Association.

Timely annual ocular examinations increased to 86% in 90 days, thus improving current DM treatment guidelines in primary care.