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Exploring point-of-care transformation in diabetic care: A quality improvement approach
  1. Malvika Juneja,
  2. Maria C. Mejia de Grubb,
  3. Haijun Wang,
  4. Kiara Spooner and
  5. Roger J. Zoorob
  1. Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
  1. Corresponding Author: Malvika Juneja, MD and Maria C. Mejia de Grubb, MD, MPH, Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA, Tel.: +713-798-4735, E-mail: juneja{at}, maria.mejiadegrubb{at}


Objective This quality improvement project evaluated the impact of a point-of-care (POC) HbA1c stat lab intervention and a nurse-assisted expanded visit implemented among patients with uncontrolled type 2 diabetes (T2D) at a community health center in Houston, TX.

Methods This was a before-and-after POC intervention among adult patients who received primary care services between 1 July 2014 and 31 December 2014 (baseline visit) and who had at least one 3-month follow-up visit.

Results Three hundred eighty-seven patients were included in the study. The majority were <60 years of age (72.1%), female (60.5%), and Hispanic (63%), followed by black (16.5%) and Asian (11.1%). Almost 87% of the patients had uncontrolled T2D (HbA1c >9%) at baseline, with the highest average levels among Hispanic (10.9%) and black (10.7%) patients. There was a significant difference in the HbA1c level before (mean=10.65, SD=1.9291) and after (mean=9.25, SD=1.8187) intervention. The absolute reduction in the level of HbA1c was 1.4% (t=12.834, p<0.001), corresponding to a 13% overall percentage decrease from baseline.

Conclusion There is a distinct advantage in using a stat HbA1c lab when combined with shared POC visits to assist patients with uncontrolled T2D in lowering the HbA1c, improving self-management, and reducing long-term costs.

  • Diabetes
  • point of care
  • stat HbA1c

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See

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