Diabetes is a national health problem that disproportionately impacts minority and low-income communities and yet one in five people don’t know they have it. At Alameda Health System (AHS) a recent study led to quality improvements that empowered diabetic patients with the education, resources, and diabetes management tools and helped increase revenue.

Nicky Reynicke, RN and certified diabetes care and education specialist at Highland Wellness authored a Quality Incentive Program (QIP) study to show the impact on health outcomes for diabetic patients when non-physician teams were involved in their care and disease management.

A total of 77 diverse Highland Wellness diabetes patients from six different racial and ethnic groups participated in the study. It was designed to evaluate the outcomes for diabetic patients assigned to a registered nurse (RN)-led panel using Diabetes Self-Management Education and Support (DSMES) standards compared to patients assigned to a primary care provider (PCP)-led panel.

“The results showed that patients assigned to both the RN-led and PCP-led panels had significant improvements at six months in their hemoglobin or blood sugar measures. In addition, the RN-led panel had fewer emergency department visits when compared to patients followed by primary care physicians alone,” said Reynicke.

Throughout the study, Reynicke guided patients through diabetes management practices including education on the importance of medication and blood sugar monitoring as well as healthy eating and regular exercise.

One of Reynicke’s patients, a 69-year-old Asian American male was confused about his various medications including what they were for and the best time to take them. With Reynicke’s support, the patient learned how to take his medications as prescribed, and now understands the connection between checking his glucose levels before and after meals and interpreting the data to adjust his lifestyle habits as needed.

Recently, the patient told Reynicke that he was determined to make him proud. “This makes me smile,” said Reynicke. “I’m already proud when I see my patients coming to their appointments willing to listen, learn and make the necessary changes to thrive. They should be proud of themselves.”

The QIP study was published in the October 2023 issue of Nursing Economic$ Journal and resulted in the chronic disease management program in adult medicine securing accreditation as an official DSMES provider in 2023.

According to Reynicke, a retrospective research method was used to evaluate the program’s patient outcomes as well as the financial outcomes. The accreditation as a DSMES provider enabled RNs to bill for DSMES services resulting in additional funding to support diabetic patient care.

The six month QIP study that took place at Highland Wellness was comprised of a chronic care multidisciplinary team including Jennifer Toy, clinical pharmacy specialist, adult medicine and Brenda Rhodes, medical assistant, ambulatory services.

For more information on diabetes care, management and prevention, visit the National Institutes of Health (NIH).