Dr. Nancy Morris: 3 Steps to Top Quartile Diabetes Measures

Dr. Nancy Morris, a provider with KentuckyOne Health Primary Care Associates in London, KY, is achieving high scores with diabetes measures and having success closing care gaps in that patient population. Dr. Morris shares three focus areas that have made a difference in her office.

  1. Make diabetic patients a priority population for your office.

“Because of our patient population, we made diabetic patients a focus long before being asked. We closely monitor this population, seeing them every 3 months so they don’t go beyond that time frame without assessing their A1c. Since the body adapts to sugar readings, patients who aren’t screened often may not realize they don’t feel well and may not have recognizable symptoms. Our goal for a diabetic patient’s HgA1c is 6.5 or less.”

2. Patients are in denial. Make sure they understand the consequences of non-compliance.

“I don’t think our office is doing anything unique, but we do spend considerable time discussing exercise, diet/ nutrition and medication compliance. In fact, we spend probably 90% of a patient’s appointment talking about significant morbidities and mortality if the patient is not compliant. Some patients are in total denial that they have Type 2 diabetes, and what they eat creates the problem. We aren’t trying to scare our patients, but we want to make sure they understand the reality of what will happen if they don’t cooperate to help manage the disease. We try to keep things simple. For example, I tell patients to make sure half of their plate includes something dark green, with limited amounts of meat and carbs. In addition, sharing with patients that if they make lifestyle changes with their diet and exercise, there is potential for patients to be able to stop medication, so they wouldn’t have to take medicine the rest of their lives. This is welcomed news.”

3. Educating staff about documentation is a game-changer.

“We have given our staff extensive education about documentation and recording accurately in the patient’s medical record outside lab values and diabetic eye exams in addition to other important health maintenance results; that training has made a significant difference in our office. We have worked hard to make sure our office staff follows through on results of ordered tests and ensuring these results are recorded – not just scanned – so documentation is complete. I also document lifestyle modification advice and counseling during a patient’s office visit to make sure all of the information I am sharing is recorded. It does take a few extra clicks, but ensuring the work we do is captured appropriately is definitely worth it.”