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Sample chart review tool from session on diabetes mellitus type 2
| Chronic disease data | Patient A data | Patient B data |
|---|---|---|
| Patient Identifier | ||
| Date of Last visit | ||
| Age | ||
| Comorbidities (Coronary Artery Disease, Stroke, Hypertension) | ||
| Tobacco | ||
| Hemoglobin A1c / date | ||
| Medications | ||
| Medications refilled as expected? | ||
| Last blood pressure / date | ||
| Body Mass Index | ||
| Urine microalbumin / date | ||
| LDL cholesterol / date | ||
| Dilated retinal exam result / date |
Write three observations for improvement: 1 2 3
