A system-based intervention to improve postpartum diabetes screening among women with gestational diabetes - 27/09/12
, Patricia M. Dietz, DrPH, MPH b, Joanna Bulkley, PhD a, F. Carol Bruce, BSN, MPH b, William M. Callaghan, MD, MPH b, Lucinda England, MD, MSPH b, Terry Kimes, MS a, Donald J. Bachman, MS a, Karen J. Hartinger, RN a, Mark C. Hornbrook, PhD a
Reprints: Kimberly K. Vesco, MD, MPH, Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave., Portland, OR 97227-1110Résumé |
Objective |
We sought to determine whether our process improvement program led to increased postpartum diabetes screening rates among women with gestational diabetes mellitus (GDM).
Study Design |
In early 2009, we conducted obstetrics department staff education sessions, revised GDM patient care protocols, and developed an electronic system to trigger reminder calls to patients who had not completed diabetes mellitus screening by 3 months postpartum. We then evaluated the rates of postpartum glucose test order entry and completion for women with GDM delivering from July 2009 through June 2010 (n = 179) and July 2007 through June 2008 (n = 200).
Results |
After the program's implementation, the proportion of women receiving an order for a postpartum glucose test within 3 months of delivery increased from 77.5-88.8% (P = .004), and test completion increased from 59.5-71.5% (hazard ratio, 1.37; 95% confidence interval, 1.07–1.75).
Conclusion |
Rates of postpartum diabetes testing can be improved with system changes and reminders.
Le texte complet de cet article est disponible en PDF.Key words : gestational diabetes, postpartum, reminders, screening
Plan
| The obstetrics department of a large prepaid health maintenance organization was the setting of this study. Funded by contract number CDC 200-2009-31663, “Extent of Maternal Morbidity in a Managed Care Setting,” Centers for Disease Control and Prevention. |
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| The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or Kaiser Permanente Northwest. |
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| The authors report no conflict of interest. |
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| Cite this article as: Vesco KK, Dietz PM, Bulkley J, et al. A system-based intervention to improve postpartum diabetes screening among women with gestational diabetes. Am J Obstet Gynecol 2012;207:283.e1-6. |
Vol 207 - N° 4
P. 283.e1-283.e6 - octobre 2012 Retour au numéro
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