Table 4 Examples of actions identified in the regional mandate
Problem area | Action | Quality indicator to measure impact of benchmarking |
|---|---|---|
Many patients with microalbuminuria are not treated with ACE-inhibitors and/or ARBs | Use of an ad hoc query on the electronic clinical record to identify these patients | Reduction in the percentage of patients with microalbuminuria not treated with ACE-inhibitors and/or ARBs |
Many patients with LDL-cholesterol ≥130 mg/dl are not treated with lipid-lowering agents | Use of an ad hoc query on the electronic clinical record to identify these patients | Reduction in the percentage of patients with LDL-C ≥130 mg/dl not treated with lipid-lowering agents |
Poor proactive involvement of patients in the process of care | Identification of a model of “therapeutic contract”, with discussion and agreement on therapeutic goals and appointments for regular monitoring of diabetes complications | Increase in the percentage of patients reaching HbA1c, blood pressure and LDL-cholesterol targets. Increase in percentage patients monitored for nephropathy, retinopathy and diabetic foot |
Poor attention to patient with low levels of psychological well-being | Use of WHO-5 to identify patients with score <28; referral for specific counseling, identification of barriers and solutions | Increase in mean values of WHO-5 and DES-SF scores and decrease in mean values of PAID-5 |