Table 7.

Diabetes Performance Measures: Majuro Hospital Diabetes Clinic, 2010

Measure	Performance Criteria
Frequency of visits	If meeting goals: Every 4–6 months If not meeting goals: Every 3 months or as indicated
Fasting or random blood sugar	Every diabetic visit
Weight/Height (BMI)	Every visit
Cardiovascular assessment	BP every visit EKG/CXR: Baseline PRN ASA therapy for patients >40 years old K+ level: Once or if indicated
Feet examination	Foot exam without shoes/socks: Every visit Lower extremity sensory exam: Perform a comprehensive vascular, neurologic, musculoskeletal, skin and soft tissue exam at least once a year (See Diabetes Foot Screening Form)
Eye examination	Dilated eye examination yearly (Type 2) Dilated eye examination 3–5 years (Type 1)
Lipid profile	Initial diagnosis: Total cholesterol and triglycerides If total cholesterol >200mg/dl: Lipid counseling If total cholesterol >240mg/dl: Check HDL and LDL, start statins If meeting goals: Annual or as indicated If not meeting goals: Every 3–4 months or as indicated
Hemoglobin A1c	Every 3–6 months
Creatinine	Annual or every 3–6 months if abnormal
UA for Microalbumin	Annual: If >30mg, start ACE inhibitor
Flu vaccine	Annual
Pneumovax	Once
Tetanus toxoid	Every 10 years
Nutritional therapy	2 or more per year
Health Education/Self-Management Training	SBGM: Blood glucose monitoring should be encouraged in all patients to help reachand maintain treatment goals Education visits: 1 or more per year Educational needs should be assessed at time of diagnosis and when there is poor clinical control or a major change in therapy Self-management education needs and plans should be documented in the medical record and acknowledged by all providers
Oral/Dental screening	Annual
Smoking cigarettes	Advise to quit smoking: Every visit
Other metabolic conditions	Uric acid: Annual CBC: Once or as indicated

Data source: Personal communication, Dr. R. Maddison (October 21, 2010)