Michigan Quality Improvement Consortium: Diabetes Mellitus Patient Checklist - Version 2

QualityTool

Michigan Quality Improvement Consortium: Diabetes Mellitus Patient Checklist - Version 2

Description

This checklist is for providers treating patients with diabetes mellitus. It is based on the clinical practice guideline created by The Michigan Quality Improvement Consortium for the treatment of patients with diabetes mellitus, which applies to patients with type 1 and type 2 diabetes mellitus and recommends specific interventions for periodic medical assessment, laboratory tests, and education to guide effective patient self-management.

Providers may use this checklist to keep track of the care of their patients with diabetes. This checklist provides a standardized method to collect the following information about each patient:

  • Height
  • Weight
  • Body mass index
  • Blood pressure: (adult target less than or equal to 130/80)
  • Foot exam
  • Tobacco use
  • Cardiovascular risk assessment
  • Behavioral health assessment
  • Lab tests and other studies
  • Counseling
  • Medical recommendations

Developer:

Michigan Quality Improvement Consortium

Funding Sources:

Michigan Quality Improvement Consortium

History

Release Date: 2004
Review Date: 2008
Recent Summary: April 2008
Original Summary: December 2004
Last Updated: 04/25/08

QualityTool Classification

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