Table 4.

Examples of actions identified in the regional mandate

Problem area	Action	Quality indicator to measure impact of benchmarking
Many patients with microalbuminuria are not treated with ACE-inhibitors and/or ARBs	Use of an ad hoc query on the electronic clinical record to identify these patients	Reduction in the percentage of patients with microalbuminuria not treated with ACE-inhibitors and/or ARBs
Many patients with LDL-cholesterol ≥130 mg/dl are not treated with lipid-lowering agents	Use of an ad hoc query on the electronic clinical record to identify these patients	Reduction in the percentage of patients with LDL-C ≥130 mg/dl not treated with lipid-lowering agents
Poor proactive involvement of patients in the process of care	Identification of a model of “therapeutic contract”, with discussion and agreement on therapeutic goals and appointments for regular monitoring of diabetes complications	Increase in the percentage of patients reaching HbA1c, blood pressure and LDL-cholesterol targets. Increase in percentage patients monitored for nephropathy, retinopathy and diabetic foot
Poor attention to patient with low levels of psychological well-being	Use of WHO-5 to identify patients with score <28; referral for specific counseling, identification of barriers and solutions	Increase in mean values of WHO-5 and DES-SF scores and decrease in mean values of PAID-5