Improving access to diabetes care in an inner-city, community-based outpatient health center with a monthly open-access, multistation group visit program.

OBJECTIVE

To describe the development and implementation of a multifaceted program in an inner-city healthcare center designed to improve access to care and empower patients to take a more active role in managing diabetes.

PROCEDURES

AHC is one of 30 outpatient health centers in the Ambulatory and Community Health Network of the Cook County Bureau of Health Services. AHC serves a predominantly African-American population with four full-time-equivalent primary care providers treating approximately 700 diabetes patients with >450 waitlisted patients, many with diabetes. Budget constraints limit capacity to add providers. In January 2005, open-access, multi-station group visits were implemented to improve access to care and empower patients to take a more active role in managing diabetes. The program is called Diabetic Rewards Issued Via Everyone (DRIVE) Day. Elements include: 1. group visits held monthly; 2. patient-selected activities, including diabetes education, nutrition, exercise, group discussions and Q&A sessions; 3. provider support, including implementation of evidence-based guidelines for glycemic, lipid and hypertension management, retinal screening, foot exams and medication adjustment; and 4. web-based patient registry

FINDINGS

Of the clinic's 737 diabetes patients, 294 (40%) have attended > or =1 DRIVE Days, for a total of 775 patient encounters between January 2005 and October 2006.

CONCLUSIONS

In an environment with limited resources, DRIVE Day has improved access to care, provided an opportunity for diabetes patients to take a more active role in their care and enabled providers to see a higher volume of patients and offer efficient, comprehensive care.