SAT-866 - Impact of Resident-Focused Diabetes Education on Guideline-Recommended Screening and Glycemic Trends in the Outpatient Setting: A Quality Improvement Initiative

Background
Guideline-recommended diabetes care emphasizes timely hemoglobin A1c (HbA1c) assessment, individualized glycemic management, and routine screening for microvascular complications. Resident physicians play a central role in outpatient diabetes management, yet the real-world impact of resident-focused diabetes education on adherence to recommended screening and glycemic outcomes is not well characterized.
Objective
To evaluate the impact of a resident-focused diabetes education initiative on adherence to guideline-recommended screening and glycemic control in a residents’ outpatient clinic.
Methods
We conducted a pre–post quality improvement study among adult patients with diabetes cared for by resident physicians in outpatient settings. Two educational interventions were implemented: small-group didactic sessions and institution-wide grand rounds. Educational outcomes were assessed using pre- and post-intervention knowledge assessments consisting of distinct but conceptually aligned board-style questions. Process measures included completion of guideline-recommended screening (microalbuminuria, retinopathy, and foot examinations) among patients without documented prior screening before the intervention. Glycemic outcomes, including A1c distributions and changes, were assessed descriptively among patients with available laboratory data.
Results
Baseline knowledge assessment demonstrated a mean score of 75.6% among participating residents, while post-intervention assessment demonstrated a mean score of 68.9%. During the three-month post-intervention period, completion of guideline-recommended screening increased among patients without documented prior testing. Microalbuminuria screening completion rates were 25.0% (9/36; 95% CI, 12.1–42.2%) following small-group sessions and 29.0% (9/40; 95% CI, 14.2–48.0%) following grand rounds. Retinopathy and foot examination completion rates remained low (4.6–5.3% and 6.4–7.5%, respectively). Among patients with non-missing follow-up A1c values, the proportion with A1c >9% decreased from 16.8% to 9.4% after small-group sessions and from 13.0% to 8.1% after grand rounds. Median A1c change was modest (–0.1%), with greater variability in mean changes.
Conclusion
Resident-focused diabetes education was associated with modest improvements in select guideline-recommended screening processes and a directional reduction in poorly controlled diabetes over a three-month period. Stable median and mean A1c values suggest targeted short-term improvement among high-risk patients, with interpretation limited by short follow-up and missing data.

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