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Applying National Diabetic Care Standards for the Management of a Hispanic Population Attending a Free Clinic

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Abstract

Background: National quality measures set goals for diabetes management. Hispanic populations are higher risk for diabetes and associated complications, especially low-income communities. Research suggests free clinics provide suboptimal diabetes management. Our quality improvement project aims to improve diabetes management in the Hispanic free clinic population. Methods: Clínica Latina’s volunteer medical students and physicians serve predominantly uninsured Spanish-speaking patients. Established diabetes patients that attended clinic during the study were included. Data was collected regarding patients’ diabetes care for two months, then analyzed compared to quality metrics. We implemented paper checklists and electronic medical record (EMR) smart phrases for volunteers to utilize in managing diabetes. Results: 32 patients were included in the study. At baseline, 78% had an A1C check in the past 3 months, 81% were on a statin. In the past year, 81% had a lipid panel, 19% had an eye exam, 63% had a diabetic foot exam, 53% had a urine microalbumin-creatinine screening. After interventions, 97% had an A1C check, 93% were on a statin, 91% had a lipid panel, 31% had an eye exam, 75% had a foot exam, 63% had a urine microalbumin-creatinine. Patients with an LDL < 100 increased from 62 to 66%. The mean A1C did not statistically significantly change. Volunteer smart phrase utilization increased from 37 to 59.1%. Conclusion: We implemented a checklist and EMR smart phrase to optimize diabetes management in a student-run Hispanic free clinic, which improved quality metrics. Low-resource clinics serving Spanish-speaking populations may benefit from similar interventions to improve diabetic care.

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Authors and Affiliations

  1. Ohio State University Wexner Medical Center, Columbus, OH, USA

    Emily Lawson, Vamsee Vemulapalli, Kathleen Wyne & Summit Shah

  2. Ohio State University, Columbus, OH, USA

    Anthony Barnes

  3. Contra Costa Regional Medical Center, Martinez, CA, USA

    Sara Scott

  4. Nationwide Children’s Hospital, Columbus, OH, USA

    Summit Shah

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  1. Emily Lawson
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  2. Vamsee Vemulapalli
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Correspondence to Emily Lawson.

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Lawson, E., Vemulapalli, V., Barnes, A. et al. Applying National Diabetic Care Standards for the Management of a Hispanic Population Attending a Free Clinic. J Community Health 48, 576–584 (2023). https://doi.org/10.1007/s10900-023-01199-4

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