Improving Diabetes Screening in the Primary Care Clinic

Area of Science:

• Primary Care Medicine
• Quality Improvement Science
• Health Informatics

Background:

• Low diabetes screening rates (51%) in primary care settings mirror national trends, indicating a need for improved detection strategies.
• Eligible patients require systematic screening for early identification of diabetes, a growing public health concern.

Purpose of the Study:

• To implement and evaluate a quality improvement project aimed at increasing diabetes screening rates within a suburban primary care clinic.
• To assess the effectiveness of a two-phase intervention utilizing electronic health record (EHR) functionalities to enhance screening.
• To evaluate physician satisfaction and intervention acceptability.

Main Methods:

• A 6-month preintervention phase collected baseline screening data.
• A two-phase intervention was implemented: Phase 1 used EHR reports and pended orders; Phase 2 employed an EHR clinical decision support tool.
• Screening rates were compared pre- and post-intervention, with additional data on laboratory completion and physician feedback.

Main Results:

• Weekly diabetes screening rates increased significantly from 51% to 65% (p < 0.001).
• During Phase 1, 83% of patients completed recommended laboratory testing within 3 months, with 23% showing prediabetes and 4% diabetes.
• Physician feedback indicated high satisfaction, with 100% agreeing the intervention was helpful by 9 months.

Conclusions:

• A systematic quality improvement intervention, integrating manual workflows and EHR tools, effectively enhanced diabetes screening rates in a primary care setting.
• The study demonstrates the successful implementation of an EHR-based strategy to improve adherence to diabetes screening guidelines.
• The findings support the use of technology-driven interventions to improve chronic disease screening and management in primary care.