Objective:This quality improvement project evaluated the impact of a point-of-care(POC)HbA1c stat lab intervention and a nurse-assisted expanded visit implemented among patients with uncontrolled type 2 diabetes(T2D)a...Objective:This quality improvement project evaluated the impact of a point-of-care(POC)HbA1c stat lab intervention and a nurse-assisted expanded visit implemented among patients with uncontrolled type 2 diabetes(T2D)at a community health center in Houston,TX.Methods:This was a before-and-after POC intervention among adult patients who received primary care services between 1 July 2014 and 31 December 2014(baseline visit)and who had at least one 3-month follow-up visit.Results:Three hundred eighty-seven patients were included in the study.The majority were<60 years of age(72.1%),female(60.5%),and Hispanic(63%),followed by black(16.5%)and Asian(11.1%).Almost 87%of the patients had uncontrolled T2D(HbA1c>9%)at baseline,with the highest average levels among Hispanic(10.9%)and black(10.7%)patients.There was a significant difference in the HbA1c level before(mean=10.65,SD=1.9291)and after(mean=9.25,SD=1.8187)intervention.The absolute reduction in the level of HbA1c was 1.4%(t=12.834,p<0.001),corresponding to a 13%overall percentage decrease from baseline.Conclusion:There is a distinct advantage in using a stat HbA1c lab when combined with shared POC visits to assist patients with uncontrolled T2D in lowering the HbA1c,improving self-management,and reducing long-term costs.展开更多
基金This research received no specific grant from any funding agency in the public,commercial,or not-for-profit sectors.
文摘Objective:This quality improvement project evaluated the impact of a point-of-care(POC)HbA1c stat lab intervention and a nurse-assisted expanded visit implemented among patients with uncontrolled type 2 diabetes(T2D)at a community health center in Houston,TX.Methods:This was a before-and-after POC intervention among adult patients who received primary care services between 1 July 2014 and 31 December 2014(baseline visit)and who had at least one 3-month follow-up visit.Results:Three hundred eighty-seven patients were included in the study.The majority were<60 years of age(72.1%),female(60.5%),and Hispanic(63%),followed by black(16.5%)and Asian(11.1%).Almost 87%of the patients had uncontrolled T2D(HbA1c>9%)at baseline,with the highest average levels among Hispanic(10.9%)and black(10.7%)patients.There was a significant difference in the HbA1c level before(mean=10.65,SD=1.9291)and after(mean=9.25,SD=1.8187)intervention.The absolute reduction in the level of HbA1c was 1.4%(t=12.834,p<0.001),corresponding to a 13%overall percentage decrease from baseline.Conclusion:There is a distinct advantage in using a stat HbA1c lab when combined with shared POC visits to assist patients with uncontrolled T2D in lowering the HbA1c,improving self-management,and reducing long-term costs.
