The rising incidence and prevalence of diabetes mellitus and its associated chronic complications have become major out-of-control health problems impacting the national healthcare system. The need for comprehensive community-based models for prevention, detection, and treatment of diabetes and associated co-morbidities is critical. Diabetes is the most costly chronic disease in the United States, costing an average $15,000 per patient per year; the disease afflicts 1 in 100 Americans, and its incidence has risen by 65% over the last ten years. The purpose of this paper is to present concepts for implementing a reminder system to recall individuals with type 2 diabetes mellitus (T2DM) and to discuss project implementation of such in a clinical setting. The vast numbers of individuals with diabetes and their need for regular exams and lab testing challenge providers to adequately manage this group. In this paper is a discussion of the application of an evidence-based practice systematic approach to treatment for diabetes, commonly called Staged Diabetes Management (SDM) that helped set the stage for implementing a new reminder system in the quest to reduce morbidity/mortality of patients with diabetes. After a literature search that confirmed the need for a practice change using structured guidelines, clinic staff developed tools for identifying and tracking patients. The Iowa Model of Evidence-Based Practice guided the steps to successful design, tool development, and methods for implementing and evaluating the process. The same-patients six-month project compared number of visits to the two previous years before the intervention. The result was that 29 of 30 patients in the project increased their number of visits allowing the opportunity to implement SDM protcols. Post project results indicated steady improvement of HgA1c results.
