School of Medicine

Background : Diabetic retinopathy affects millions of Americans every year and is the leading cause of blindness in the United States. The prevention and treatment of diabetic retinopathy is well documented. Well-regulated glucose and blood pressure levels have been shown to help in preventing retinopathy in diabetic patients. Advances in treatment, such as retinal laser photocoagulation and vitrectomy have helped lower the risk of blindness, but diabetic retinopathy continues to be a major concern for diabetic patients. The best method of prevention appears to be annual ophthalmologic screenings. After a recent study of diabetic patients at the UCSD Student-run Free Clinic Project found that only 32% of diabetic patients received their annual ophthalmology exam in 2009 (Smith), new population-based systematic measures were implemented to improve the diabetic ophthalmology screening rates. This study discusses the implementation and results of those measures. Methods : Systems-based changes included adding date of last ophthalmology visit on diabetic SOAP notes, improved referral sheets that include prioritizing patients based on urgency, proactively identifying and calling diabetic patients using a designated Spanish-speaker, instituting same-day walk-in appointments, increasing frequency of ophthalmology clinics, generating yearly reports, and educating diabetic patients on the symptoms and risks associated with diabetic retinopathy. The project was initiated in 2011 and ran until December 2013. The criteria for querying the database included all patients with at least one diagnosis of diabetes and all patients who had seen General Free Clinic during the years 2010, 2011, 2012, and 2013. Results : In 2009, based on Smith's study, only 32% of diabetic patients received diabetic retinopathy screening at the UCSD Student-run Free Clinic Project. The 2009 study was conducted at a time when there was only one clinic site offering ophthalmology specialty clinics (the Downtown clinic site). Once ophthalmology service.