학술논문

Applying National Diabetic Care Standards for the Management of a Hispanic Population Attending a Free Clinic.
Document Type
Article
Source
Journal of Community Health; Aug2023, Vol. 48 Issue 4, p576-584, 9p, 2 Charts, 3 Graphs
Subject
Hispanic Americans
Medical students
Diabetes prevention
Glycosylated hemoglobin
Statins (Cardiovascular agents)
Albumins
Uncompensated medical care
Quality assurance
Descriptive statistics
Electronic health records
Outpatient services in hospitals
Eye examination
Creatinine
Ohio
Language
ISSN
00945145
Abstract
Background: National quality measures set goals for diabetes management. Hispanic populations are higher risk for diabetes and associated complications, especially low-income communities. Research suggests free clinics provide suboptimal diabetes management. Our quality improvement project aims to improve diabetes management in the Hispanic free clinic population. Methods: Clínica Latina's volunteer medical students and physicians serve predominantly uninsured Spanish-speaking patients. Established diabetes patients that attended clinic during the study were included. Data was collected regarding patients' diabetes care for two months, then analyzed compared to quality metrics. We implemented paper checklists and electronic medical record (EMR) smart phrases for volunteers to utilize in managing diabetes. Results: 32 patients were included in the study. At baseline, 78% had an A1C check in the past 3 months, 81% were on a statin. In the past year, 81% had a lipid panel, 19% had an eye exam, 63% had a diabetic foot exam, 53% had a urine microalbumin-creatinine screening. After interventions, 97% had an A1C check, 93% were on a statin, 91% had a lipid panel, 31% had an eye exam, 75% had a foot exam, 63% had a urine microalbumin-creatinine. Patients with an LDL < 100 increased from 62 to 66%. The mean A1C did not statistically significantly change. Volunteer smart phrase utilization increased from 37 to 59.1%. Conclusion: We implemented a checklist and EMR smart phrase to optimize diabetes management in a student-run Hispanic free clinic, which improved quality metrics. Low-resource clinics serving Spanish-speaking populations may benefit from similar interventions to improve diabetic care. [ABSTRACT FROM AUTHOR]