Diabetes care may be improved with Steno Quality Assurance Tool-A self-assessment tool in diabetes management

摘要

To evaluate if improvements in the quality of diabetes care in Indian clinics can be obtained by simple self-surveillance PC-based software. Method: Nineteen Indian diabetes clinics were introduced to the principles of quality assurance (QA), and to a software program, the Steno Quality Assurance Tool (SQAT). Data was entered for an initial 3 months period. Subsequently data were analyzed by the users, who designed plans to improve indicator status and set goals for the upcoming period. A second data entry period followed after 7-9 months. Results: QA data was analyzed from 4487 T2DM patients (baseline) and 4440 (follow-up). The average examination frequency per clinic of the following indicators increased significantly: lipid examination (72-87%) (p= 0.007), foot examination (80-94%) (p= 0.02), HbA1c investigation (59-77%) (p= 0.006), and urine albumin excretion investigation (72-87%) (p= 0.006). Outcome parameters also improved significantly: mean (SD) fasting and post prandial BG reduced from 144(16) to 132(16). mg/dl (p= 0.02) and 212(24)-195(29). mg/dl (p= 0.03), respectively. Systolic BP reduced from 139(6) to 133(4) (p= 0.0008). mmHg and diastolic BP from 83(3) to 81(3). mmHg (p= 0.002). Conclusion: Quality of diabetes care can be improved by applying SQAT, a QA self-surveillance software that enables documentation of changes in process and outcome indicators.