Cindy Welsh, RN, MBA, Facilitator, Administrator Clinical Excellence, Oak Brook Support Center and Director, Quality Improvement/Credentialing, Advocate Health Centers

Charles Derus, MD, System Team Leader, Diabetes Physician Champion, Dreyer Medical Clinic

Diane Arndt, RN, Diabetes Care Manager, Advocate Lutheran General Hospital

Bruce Bernheim, MD, Diabetes Physician Champion, Advocate Medical Group

Mary Brennan, RN, Director Quality Improvement/Utilization Management, Dreyer Medical Clinic

Sharon Gardner, RN, Director Quality Improvement, Advocate Medical Group

Sabina Markvaldas, Senior Clinical Project Analyst, Oak Brook Support Center

Pankaj Patel, MD, Diabetes Physician Champion, Advocate Health Centers

Mark Shields, MD, Diabetes Physician Champion, Advocate Health Partners

• To increase Hemoglobin A1c screening to greater than or equal to 82 percent
• To increase Lipid Profile screening to greater than or equal to 80 percent

• Percent of diabetes patients receiving HbA1c screening in last 12 months
• Percent of diabetes patients receiving Lipid Profile screening in last 12 months

• Developed and implemented an annual diabetic lab panel (FBS, HbA1c, BUN, Creatinine, Lipid Profile, Urine Microalbumin)
• Distributed the ADA diabetic management guidelines and ASA position statement to all Primary Care Practitioners (PCP)
• Constructed and distributed a “Diabetic Outcomes Profile” to each PCP (report containing screening test values, list of PCPs diabetes patient’s by HbA1c value, list of patients missing HbA1c and LDL screening, graphs comparing PCP to group and outside comparative reference)
• Measured baseline data for HbA1c and Lipid Screenings
• Diabetes Control Network (Pfizer sponsored patient education) program offered to all diabetics
• Planned and held a diabetes symposium on 9/15/04 focused on diabetes management from pre-diabetes/metabolic syndrome to managing to target and medication titration through the psychological impact of chronic illness on patient compliance.
• Adopted the International Diabetes Center Staged Diabetes Management Model at the Advocate Health Centers and Advocate Medical Group. Dreyer Medical Clinic developed a pharmacist run diabetes management clinic.

• Feedback from physicians indicates “outcomes profile” adds value – assists in patient management
• Performance at the system level is now at or above NCQA benchmarks (adopted as system goal) for screening blood tests (HbA1c and LDL)
• Improved screening outcomes for all medical groups have been realized through the implementation of the International Diabetes Center Staged Diabetes Management model and pharmacist run clinic
• Uptake of the Pfizer patient education program has been slow (opt-in program)

Cindy Welsh, RN, MBA
Administrator, Clinical Excellence
Advocate Health Care
Cindy.Welsh@advocatehealth.com