Soto Nilda I, Bazyler Laura R, O'Toole Mary L, Brownson Carol A, Pezzullo John C
The Open Door Health Center, Homestead, Florida (Dr Soto, Ms Bazyler)
National Program Office of the Robert Wood Johnson Foundation Diabetes Initiative, St Louis, Missouri (Dr O’Toole, Ms Brownson)
Diabetes Educ. 2007 Jun;33 Suppl 6:166S-171S. doi: 10.1177/0145721707304966.
The purpose of this project is to develop and implement a system of care for people with type 2 diabetes in a free clinic setting.
This project was conducted in the Homestead/Florida City community at the Open Door Health Center (a free clinic for the uninsured poor). Through a grant from the Robert Wood Johnson Foundation Diabetes Initiative, organizational and programmatic changes were made to improve care for patients with type 2 diabetes. Program participation and clinical data, incorporation of healthy practices and programs in other community organizations, and the success of collaborations were evaluated to judge program success.
Critical factors for providing health care for persons with type 2 diabetes in a free clinic setting were identified. These included reviewing and organizing medical records of patients with diabetes, developing a system that made efficient use of limited staff resources, finding an educational approach appropriate for the population served (ie, Popular Education), involving patients in self-management support roles by providing them the opportunity and training to become peer mentors, and developing strong community partnerships to complement and reinforce self-management.
Creation of a successful system of care for patients with diabetes in a free clinic setting is possible through innovative collaboration and creative program design.
本项目的目的是在免费诊所环境中开发并实施一套针对2型糖尿病患者的护理系统。
本项目在霍姆斯特德/佛罗里达城社区的开放之门健康中心（一家为未参保贫困人口服务的免费诊所）开展。通过罗伯特·伍德·约翰逊基金会糖尿病倡议提供的一笔拨款，进行了组织和规划方面的变革，以改善对2型糖尿病患者的护理。对项目参与情况和临床数据、健康实践和项目在其他社区组织中的纳入情况以及合作的成效进行了评估，以判断项目的成功与否。
确定了在免费诊所环境中为2型糖尿病患者提供医疗服务的关键因素。这些因素包括审查和整理糖尿病患者的病历、开发一个有效利用有限工作人员资源的系统、找到一种适合所服务人群的教育方法（即大众教育）、通过为患者提供成为同伴导师的机会和培训让他们参与自我管理支持角色，以及建立强大的社区伙伴关系以补充和加强自我管理。
通过创新合作和创造性的项目设计，在免费诊所环境中为糖尿病患者创建一个成功的护理系统是可行的。
