Diabetes Balanced Scorecard

Project Team:

Description of Project:

Diabetes is a chronic condition with potentially severe complications. Despite medical advances and knowledge dissemination through guidelines, there is a large evidence-practice gap. The Institute of Medicine defines Quality in healthcare as having six domains: safety, effectiveness, patient-centered, timeliness, efficient, and equitable care. Yet, traditional metrics to monitor quality in diabetes care focus mainly on “effectiveness” indicators including biological outcomes (reaching target sugars, blood pressure) and process metrics (complication screening) with little emphasis on other quality domains. In this quality initiative, we have developed a balanced scorecard (BSC) of indicators to monitor quality in diabetes care across all 6 domains of quality through broad stakeholder engagement.

In Phase 1 we completed a literature review, held patient and provider interviews to generate an initial list of candidate diabetes indicators.

In Phase 2 we completed a modified Delphi process to select the best indicators for the scorecard. There were 34 indicators after the modified Delphi panel process with representation from each quality domain.

In phase Phase 3 involved we pilot tested the 34 indicators in the scorecard to determine which indicators where feasible to track in everyday practice. Based on results from the pilot we have arrived at a final list of 11 indicators the scorecard

By developing a university-wide balanced scorecard for diabetes care, this project will not only have impact with local settings to monitor and improve quality in ambulatory diabetes care but will also support knowledge transfer and collaborative efforts to improve care across the five academic hospitals and the broader healthcare system. Adoption of the scorecard across the five institutions will help identify gaps in care to drive continuous quality improvement efforts. We also plan to disseminate the scorecard to other agencies.