Diabetes Care Strategies

1
Diabetes Care Strategies
2
Dr. Swami and staff
3
HbA1c

• In office
• In presence of patient
• Let patient read and interpret
• Correct to achieve goal
• March, June, September, December

4
A1c Monitor
5
Blood Pressure

• Buy Monitor
• Understand Goal
• Ask to keep record
• Correction to reach the goal

6
Cholesterol

• In office
• Patient gets copy, know the goal
• Correction to reach the goal
• Every 3 months until goal is reached

7
(No Transcript)
8
Mammogram

• Appropriate patients have an appointment made
  before they leave
• Reserved time slots in hospital (Friday
  afternoon)
• Compliance has been increased by 40 in our
  office!!!

9
(No Transcript)
10
(No Transcript)
11
What works

• Quantity vs. Quality
• Flow sheet
• In office testing
• Staff education
• March, June, September, December
• Improving GFR and reducing complications
• OFMQ and Staff

12
What Doesnt Work

• Manual reminder to patient
• Uninformed patients are less compliant
• High cost of medicines and health care

13

• Two Large PotsA water bearer had two large
  pots,
•  each hung on the ends of a pole whichhe
  carried across his neck. One of
• the pots had a crack in it, while theother pot
  was perfect and always
•  delivered a full portion of water.At the end
  of the long walk from the
• stream to the house, the crackedpot arrived
  only half full. For a full
•  two years this went on daily, withthe bearer
  delivering only one and
•  a half pots full of water to his house.Of
  course, the perfect pot was proud of its
  accomplishments, perfect forwhich it was made.
  But the poor
• cracked pot was ashamed of its ownimperfection,
  and miserable that it
•  was able to accomplish only half ofwhat it had
  been made to do.After 2 yrs of what it
  perceived to be
• a bitter failure, it spoke to thewater bearer
  one day by the stream."I am ashamed of myself,
  and I
•  want to apologize to you. I have beenable to
  deliver only half my load
•  because this crack in my side
• causes water to leakout all the way back to
  your house.
•  Because of my flaws, you have to doall of this
  work, and you don't get
• full value from your efforts,"the pot said. 

• The bearer said to the pot, "Did
• you notice that there were flowers onlyon your
  side of the path, but not on
•  the other pot's side? That's because Ihave
  always known about your flaw,
•  and I planted flower seeds on yourside of the
  path, and every day while
•  we walk back , you've watered them.
• For two years I have been able to pick
•  these beautiful flowers todecorate the table.
  Without you being
• just the way you are, there would not bethis
  beauty to grace the house."Moral Each of us
  has our own unique
• flaws. We're all cracked pots. Butit's the
  cracks and flaws we each have
•  that make our lives together so
  veryinteresting and rewarding. You've
•  just got to take each person for whatthey are,
  and look for the good in them.Blessed are the
  flexible, for they
•  shall not be bent out of shape.Remember to
  appreciate all the
•  different people in your life!THANK YOU,
• ALL MY CRACKPOT FRIENDS

Dr.swami and staff
14

• THANK YOU
• ALL MY CRACKPOT FRIENDS