Screening for diabetic kidney disease in primary care for the underinsured: A quality improvement initiative

Abstract

PurposeScreening rates for DKD in primary care are low, even though diabetes accounts for 44% of all new kidney disease cases. The purpose of this project was to determine if a primary care team for the underinsured improved screening and diagnosis of diabetic kidney disease (DKD) after initiating a quality improvement (QI) process. MethodsA chart audit with feedback, provider education of clinical practice guidelines, and strategies from TeamSTEPPS™ were implemented with the inter-professional primary care team. ResultsPre/post-intervention chart audit analysis showed the frequency of ordering microalbumin increased from 50.3% (n=148) to 75% (n=148), and diagnosing DKD rose from 3.3% (n=10) to 10.7% (n=21) over three months (P=.000). ConclusionImplementing a QI process in underinsured primary care centers improved the compliance of proper screening and diagnosing DKD AND introduced inter-professional practice competencies and teamwork strategies not previously recognized at the centers.