METRIC

"Measuring, Evaluating, and Translating Research Into Care"

http://www.aafp.org/metric

6 steps

1. Answer some general survey questions about your practice.
2. Review 10 patient charts using evidence-based practice performance measures.
3. Create an Action Plan of practice-based interventions based on the performance measures you need to improve.
4. Implement your Action Plan over a 3-month period.
5. Return to this METRIC module after 3 months to reevaluate your patient charts.
6. Evaluate whether and how the interventions chosen helped you improve care of your patients with diabetes.

1) first you do a really short survey

2) 10 chart reviews: Here is the Chart Review Process (their core measures)

Laboratory
Has the A1C been measured in the past 12 months? *		Yes No
Enter the patient's most recent A1C value:		(%)
Has the patient received a urine microalbumin protein screen in the past 12 months? *		Yes No Unknown Not Applicable (gross proteinuria)
Has a lipid profile been performed in the past 12 months? *		Yes No
Enter the patient's most recent total cholesterol value:		(mg/dL)
Enter the patient's most recent LDL cholesterol value:		(mg/dL)
Enter the patient's most recent HDL cholesterol value:		(mg/dL)
Enter the patient's most recent triglyceride value:		(mg/dL)
Has the patient's blood pressure been measured in the past 12 months? *		Yes No
Enter the patient's most recent systolic blood pressure value.		(mm Hg)
Enter the patient's most recent diastolic blood pressure value.		(mm Hg)
Preventive care
Has the patient had a dilated retinal exam or equivalent assessment by an ophthalmologist or optometrist in the past 12 months? *		Yes No Not Applicable (blindness) Unknown
Has the patient had a complete foot exam (by visual inspection, monofilament and pulse exam) within the past 12 months? *		Yes No Not Applicable (bilateral amputee)
Has the patient received a flu vaccine in the past 12 months? *		Yes No Not Applicable (egg alergy, Hx of drug interaction, contraindication) Unknown
Does the chart reflect a recommendation for aspirin therapy (dose >=75mg)? *		Yes No Not Applicable (patient is <>
Is the patient a smoker? *		Yes No Not Assessed
Does the chart reflect that the patient has been counseled to stop smoking? *		Yes No Not Applicable (nonsmoker)

3) then you get a report back (too big to display)

4) next it gives you some suggestions you can pick from (too many to display)

there is a pretty long list and it includes simple things like you watching a video to more involved things like including a care flowsheet, doing group visits, etc.

you can choose 1 or more of these suggestions.

5) Three months later... you reevaluate your charts (10 chart audits)

6) you get a report to compare and see how it worked