Gestational Diabetes Screening in a Family Medicine Residency Clinic

Clinic details

• Two locations 

• 23 attending physicians 

• 54 resident physicians 

• 2 pharmacists 

Project Description

Goal: Identify patients at elevated risk of gestational diabetes and offer early screening to improve their pre-partum care and to identify them as potential candidates for postpartum participation in the Diabetes Prevention Program. Specifically, increase early screening from a baseline rate of 72% to 80% of qualifying patients.

Methods:

1) Update the preceptor checklist

2) Educate faculty and residents on new process.

Results

Review of screening results:

• 134 IOB visits reviewed 

• 71/134 (53%) qualified by American College of Obstetrics and Gynecology criteria for early screening for GDM 

• 51/71 (72%) received early screening 

Of missed screens: 

• 8/71 (11.3%) did not complete early screening despite qualifying 

• 12/71 (17%) were screening status unknown  

Review of post-intervention screening results

Lesson:

Our initial observation that this may be a preceptor problem turned out to only be partially true. It was more of a public-health problem, involving both community knowledge and the workflows of referring clinics.