Diabetic Information Fluency and HBA1C Assessment

Abstract

Background: Over the last 60 years diabetes rates have risen sharply from less than 1% to nearly 8% of Americans diagnosed with diabetes. The increase has disproportionately impacted lower-income and minority members of society placing much of the burden on Federally Qualified Health Centers in both rural and urban populations. The American Diabetes Association (ADA) produces guidelines for the monitoring of care, principally though HbA1c levels. Further, the ADA has moved from an annual guideline update to a continually evolving document increasing the burden of education on providers. Purpose: To evaluate if providing educational updates on diabetes care, as a quality improvement measure, impacts clinical behavior, by way of increased levels of HbA1c assessment in guideline-recommended patients. Methods: Non-experimental, pre-test, post-test, one-group design, assessing short-term knowledge improvement after, lecture style, educational update along with a simple comparison of the rate at which providers assess patients for HbA1c control before and after updated diabetes protocol and medication education. Results: After completion of the educational update there was a modest improvement of 15.5% in post-test scores when compared to pre-test results. Comparing the 30-days prior to the 30days post educational update the rate of missed assessment opportunities fell from 13.3% to 7.2% or a positive change of 6.1% or a nearly 46% reduction in missed assessments. Conclusion: Overall, the quality improvement effort to provide educational updates on current ADA guidelines appears to have had a positive impact on increasing the rate of HbA1c assessment at a local level