Improving diabetes management: structured clinic program for Canadian primary care.

PROBLEM BEING ADDRESSED: Adherence to diabetes treatment guidelines is often poor in primary care. OBJECTIVE OF PROGRAM: To introduce simple accessible interventions in our clinic to improve both physicians' adherence to diabetes treatment guidelines and patient outcomes. PROGRAM DESCRIPTION: A physician and a nurse practitioner used 3 interventions for diabetes care: 30-minute appointments, reminder telephone calls to patients, and standardized flow sheets. Evaluation of this structured program found that, after 3 years, these interventions had improved primary caregivers' adherence to diabetes care guidelines and several physiologic parameters in patients with diabetes (compared with outcomes of patients managed with the usual less structured approach). CONCLUSION: This program improved delivery of diabetes care in our clinic. We believe a similar approach could help other physicians and nurse practitioners in primary care practices increase their adherence to guidelines and improve the clinical outcomes of their patients.