Monitoring Quality of Care

Protocol for quality development and monitoring of performance

Aggregate	the data gathered at Annual Review onto a database

Choose	indicators ( see below ) to reflect outcome as well as process of care

Analyze	data in line with published recommendations

Compare	performance with pre-determined standards or other providers of diabetes care

Review	performance at regular meetings of your diabetes team performance of education programmes

Discuss	to design and implement action plans for imprevement

Examples of indicators for quality development and monitoring

Measure :		Calculate :
Intermediate outcomes
	HbA1c	Percent with HbA_1c >7.5 and >6.5 %
	Albumin excretion	Percent with abnormal albumin excretion
	Eye damage	Percent with retinal damage
True outcomes
	Amputation above ankle	Incidence
	Myocardial infarction	Incidence
	Stroke	Incidence
	Foot ulceration	Incidence
Risk factor control
	Hypertension	Percent with blood preassure >= 140/85 mmHg
	Smoking	Percent people still smoking
Process of care
	Eyes screened	Percent people examined in year
	Education performed	Percent people seeing nurse educator in year
	Feet examined	Percent people examined in year
These are examples; many other indicators are possible