Background: The Columbus Free Clinic (CFC) is a student-run free clinic providing care to underserved residents in Central Ohio. Type 2 diabetes is the most common chronic condition diagnosed at CFC. Historical data shows CFC provides suboptimal diabetic preventative care, evidenced by non-compliance with American Diabetes Association (ADA) laboratory testing guidelines. Due to volunteer providers and students rotating weekly, a quality improvement (QI) project was developed to improve the quality of medical care for patients with diabetes by increasing volunteer adherence to a subset of ADA guidelines: documented hemoglobin A1c (HbA1c) within the past 6 months, micro-albumin/creatinine ratio (ACR) in the past 12 months, and lipid panel in the past 12 months.
Methods: In March 2023, a chart review was conducted to obtain baseline data on ADA guideline measures. A QI intervention plan to improve adherence to ADA guidelines was developed and implemented April 2023. A dot phrase in CFC’s electronic health record system was programmed with questions about laboratory testing to prompt providers to ask patients to increase adherence. In December 2023, post-intervention data was collected for patients with type 2 diabetes who were seen at CFC pre and post-intervention.
Results: Out of the 175 patients who were identified with type 2 diabetes, a subset of 71 patients visited CFC for treatment pre and post-intervention. Prior to implementation, 57.7% of patients had a recorded HbA1c in the past 6 months, 33.8% had an ACR recorded in the previous 12 months, and 67.6% had a lipid panel recorded in the past 12 months. Post intervention, these percentages increased to 66.2% (+8.5%, p=0.30), 84.5% (+16.9%, p=<0.05) and 69.0% (+35.2%, p=<0.001), respectively.
Conclusion: Findings highlight that our intervention successfully increased adherence to ADA care guidelines in a student-run, free clinic setting.
M.C. Casola: None. T. Brar: None. G. Lee: None. M. Coyne: None. N.L.J. Purdy: None.
