The fact is, diabetes care is delivered by a team of health care professionals that may include physicians, nurses, dietitians, pharmacists, certified diabetes educators, podiatrists, optometrists, and community organizations and support groups.  Physicians cannot know how effective their diabetes care is unless they evaluate their practices.  Physicians need data to identify the patients needing diabetes care and to track how standards are care are being met.  Information in this section will help physicians and other professionals identify tools and strategies created by national physician-directed organizations to assess the care clinicians are delivering and develop systems of care.  Similar resources are available for other clinical professionals.

Resources for physicians include:

National Diabetes Education Program “Better Diabetes Care” continuing education program http://www.betterdiabetescare.nih.gov/MAINintroduction.htm

American College of Physicians “Diabetes Care Guide” Quality Improvement Resources http://diabetes.acponline.org/clinician/CL-QI-QIP.html

Other resources include the Michigan Diabetes Research and Training Center, http://www.med.umich.edu/mdrtc/profs/index.htm

• Quality improvement starts with data and information about current practice. Physicians need information systems that allow them to track the diabetic patients in their panel and monitor the acute and preventive services delivered to patients.

• Supporting patient self-management is a critical element of care — patients need to understand diabetes and how to take care of themselves. A “self-management assessment” of patient knowledge and skill is important. Physicians can conduct the assessment, or make it a part of office staff intake responsibilities.

• High-tech (such as electronic health records) and low tech (flowsheets and chart stickers) approaches are available to support the work of physicians. Standard referral and report forms are available on Web sites (such as the American College of Physicians) to support coordination of care between providers.

• Many physician programs are now being adopted to promote and reward high performance.  Pay for performance, physician recognition, quality tiering, and board certification are increasingly linked to evidence that physicians are meeting diabetes standards for care.