2011 AFHTO conference presentation PRESENTER (S): Andrea Petroff, BA Honours. Psych, M.I.R. (Masters of Industrial Relations), Executive Director; Claudia Mariano, NP-PHC, MSc Primary Health FHT/ORG: West Durham FHT ABSTRACT: Our commitment to our patients, our community, and to ourselves, to provide the best possible care for chronically ill patients, meant that we needed to take a cold, hard look at how we currently manage versus how we need to be managing this vulnerable patient population. Focusing first on patients with diabetes; we took a strategic approach to establishing FHT procedures and policies that can be easily applied in managing other chronic illness. These are the tactics we employed:
- Developed outcome and monitoring goals for all Type Two diabetic patients >18yrs
- EMR review of baseline patient statistics measured against goals set
- In-depth analysis of current resources, practice design, interprofessional collaboration and office efficiencies to identify gaps that jeopardized our goals
- Prioritized actions to address areas of concern and assigned personnel to lead change for improvement
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