1. Improved performance of the Diabetes LDL control measure Dr Stuart V Demirs MD

2. Definition DM LDL testing- number of active patients with Diabetes, aged 18-75 years who had a resulted LDL value during the measurement year DM LDL Control- Number of active patients with diabetes, aged 18-75 whose most recent LDL measurement is less than 100 during the measurement year

3. Multi-step process to obtain data Conversation with patient upon diagnosis of diabetes Medication perscribed on second or third visit Need patient to “buy in” to taking cholesterol lowering medications Ensure compliance with medications and diet- referral to Nurse Care Manager

4. Entering Data in correct fields Polaris “ EPI Chart” data is entered in preventive care tab Data was “scrubbed” (some patients were not actually diabetic or were no longer our patients) LDL result received from South County Hospital lab has to be manually entered in preventive care tab

5. Role of Nurse Practitioner Education of patients Awareness of CSI measures Entering data in preventive care Team approach awareness of CSI measures in treating chronic disease Entering data in preventive care Team approach

6. Role of Nurse Care Manager Referral for diabetes education Reinforcement of diet and medication compliance Communication with physician and nurse practitioner when lab work is due or medications change. Assist in communication with outside endocrinologists and obtaining lab results from outside labs

7. LDL measure awareness Discussion of measures at monthly CSI meetings The presence of the measure has prompted us better educate and treat our patients with Diabetes and other chronic diseases Monthly discussions reinforce entering of the data into the proper fields

8. Conclusion Compliance with the LDL measure is a multi-step process, and often takes a few visits to convince the patients to comply with their medications A team approach to care and awareness of entering data into the proper fields has helped us to improve our data for the LDL control measure of diabetes