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U.S. Department of Health and Human Services
Health Resources and Services Administration
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Diabetes HbA1c {Poor Control}

Part 1: Introduction

Part 2: Characteristics for Success: Diabetes HbA1c

Part 3: Implementation of Clinical Quality Measure: Diabetes HbA1c

Part 4: Improvement Strategies: Diabetes HbA1c

Part 5: Holding the Gains and Spreading Improvement

Part 6: Supporting Information

Part 6: Supporting Information 

Case Study

To gain insight into how one QI team approached this measure, review a case study highlighting Healthy Valley Clinic's approach to improving Diabetes HbA1c performance.

  1. American Diabetes Association. National Diabetes Fact Sheet Exit Disclaimer.
  2. Diabetes Control and Complications Trial Research Group. The absence of a glycemic threshold for the development of long-term complications Diabetes. 1996;45:1289-1298.
  3. UK Prospective Diabetes Study Group: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-853. IBID.
  4. Diabetes Disparities Among Racial and Ethnic Minorities Fact Sheet
  5. The State of Health Care Quality 2008 Exit Disclaimer.
  6. Institute of Medicine. Breakthrough Series College Aim Statement Checklist Boston: Institute for Healthcare Improvement. February 2004 Exit Disclaimer.
  7. Adapted from pre-work manual used in HRSA sponsored Health Disparities Collaborative Exit Disclaimer.
  8. NQC "A Guide to Consumer Involvement" Exit Disclaimer.
  9. Adapted from pre-work manual used in HRSA sponsored Health Disparities Collaborative Exit Disclaimer.
  10. Timmermans S, Mauck A (2005). The promises and pitfalls of evidence-based medicine. Health Aff (Millwood) 24 (1): 18–28. doi:10.1377/hlthaff.24.1.18. PMID 15647212.
  11. The American Diabetes Association Guidelines Exit Disclaimer.
  12. The American Association of Clinical Endocrinologists/American College of Endocrinology guidelines Exit Disclaimer.
  13. Adapted from Chronic Care Model.  
  14. Langley G., Nolan K., Nolan T., Norman C., Provost L. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco. Jossey-Bass, 1996
Additional Resources
  1. American Diabetes Association: Exit Disclaimer. - General diabetes information.
  2. Improving Chronic Illness Care: Exit Disclaimer. - Dedicated to sharing strategies for improving how care teams deliver care for chronic illness
  3. Institute for Healthcare Improvement: Exit Disclaimer. - General topics and strategies for improvement, including diabetes care.
  4. Diabetes Training Manual

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