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Hemoglobin A1c Clinic Improving Diabetes Care. Patti Wascom, FNP, CDE Ashley Waggoner, PA Jane Whitney, RN, BSN Joanne Paige, LPN. Louisiana. Highest Diabetes mortality rate in the nation (35.5 / 100,000) persons Cost of Diabetes care in 2007 $2.43 billion dollars
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Hemoglobin A1c Clinic Improving Diabetes Care Patti Wascom, FNP, CDE Ashley Waggoner, PA Jane Whitney, RN, BSN Joanne Paige, LPN
Louisiana • Highest Diabetes mortality rate in the nation (35.5 / 100,000) persons • Cost of Diabetes care in 2007 $2.43 billion dollars Diabetes Prevention and Control Program-2007 Diabetes Report. Louisiana Department of Health and Hospitals.
Identified Need at BMC • Diabetes Disease Management Quarterly Report • Monthly A1c reports generated by lab
We Have a Problem! • Average 228 A1c drawn monthly • Average 40 A1c > 10% monthly A1c Clinic Proposed
A1c Clinic • Began July 2009 • 4 hour weekly clinic • Staff • Mid-level provider • RN • LPN • 347 scheduled-132 attended • Average visits per patient- 2.3
High Risk Patients • Average A1c 11.5% • 36% documented A1c >10% more than 1 year • 39% positive microalbumin
Clinic Structure • Initial visit • Follow-up at 2-8-12 weeks • Referrals • Ophthalmology • Formal Diabetes Education • Diabetic Support Group • TLC (weight management) • Endocrinology • Psychology • Repeat A1c- if at goal Discharge
A1c Clinic Content • Purpose • Review current knowledge • Review current treatment plan • Patient Agreement • Appropriate modifications • Education
Principal’s Office • Initial Evaluation • Identify Barriers • Financial • Psychological • Social • Physical
Conclusion • Patients with improved glucose control • Reduced risk of mortality • Improved quality of life • Reduced financial burden