Within the United States the number of patients affected by diabetes is rapidly increasing. With that increase, a growing cost in dollars and lost productivity is also expected. Poorly managed diabetes as a result of an ineffective health care system or lack of patient involvement leads to increased complications of the disease and ultimately a poor outcome. Accordingly, it is essential for health care providers to improve patient engagement in disease management and quality of care and outcomes. In the San Joaquin Valley of Central California, prevalence of diabetes continues to escalate and the latest statistics provided by the California Department of Public Health estimates one in ten persons in the San Joaquin Valley has diabetes. Applying strategies demonstrating even small improvements in A1c testing and resulting in obtaining optimal values can help to combat morbidity and mortality in the San Joaquin Valley of California. The Agency for Healthcare Research and Quality (AHRQ) suggested diabetes care has continued to fall short of recommended standards of care. A high priority should be given to using evidence-based practice (EBP) in any such strategy. The AHRQ suggests the implementation of at least two quality improvement strategies can have some impact on patient compliance with disease management. To meet this challenge, a practice change utilizing two strategies to improve patient engagement in their disease management was proposed and implemented. The practice change in diabetes care included: (a) telephone reminders for glycosylated hemoglobin testing; (b) disease management monitoring by the nurse practitioner.
