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Eliminating routine glucometer readings makes primary care visits more efficient, according to a 6-month review of activity at a primary care clinic. The results were published online Sept. 26 in JAMA Internal Medicine.
“The routine tasks that are components of rooming the clinic patient are increasing in number,” wrote James L Wofford, MD, of Wake Forest University, Winston-Salem, N.C., and his colleagues (JAMA Intern Med. 2016 Sep 26. doi: 10.1001/jamainternmed.2016.5769). Routine glucometer readings are costly in terms of time, money, and mental energy of clinicians, and do not add value, they wrote.
The researchers compared data from a primary care clinic in North Carolina for 3 months before and 3 months after the clinic eliminated routine glucometer readings (Jan. 1, 2015, to March 15, 2015, and March 16, 2015, to June 30, 2015). After a 1-week trial during which no routine clinical glucometry was performed, the option remained available at the request of a nurse or patient.
The number of glucometer readings decreased from approximately 400 per month to 100 per month after the change in policy, yielded a cost savings of at least $2,000 per month, and time saving of 25 hours of nursing time per month.
“Despite the fear of missing an occasional markedly elevated glucose level, clinicians gradually grew comfortable and never reconsidered reinstitution of routine glucometer readings,” Dr. Wofford and his associates wrote. However, some patient education was needed to reassure those who were disappointed by the change.
“As important as the lesson that routine glucometer readings in the clinic is a wasteful practice, the more important lesson is that examining office routines for foolish consistencies should be a regular component of making primary care more efficient,” the researchers added.
They had no financial conflicts to disclose.
Cutting down on unnecessary procedures allows primary care physicians to optimize their time with patients, and curbing routine glucose testing saves time and money, Adam J. Schoenfeld, MD, and Patrick G. O’Malley, MD, wrote in an editorial.
“Changing this policy to leave glucose testing to the discretion of the patient and nurse resulted in a decrease of 300 glucometer tests per month, saving the clinic $2, 000 and 25 hours of nursing time,” they wrote.
“Patients without infectious symptoms likely do not need their temperature taken, and we probably do not need to elicit a pain severity scale in patients without an active complaint of pain,” they noted. “Instead, other issues could take priority, such as medication reconciliation; collection of important psychosocial information, such as screening for commonly undiagnosed illnesses like depression; discussing advanced directives; and preparing the patient to be more active and engaged in addressing their agenda for the visit.”
Dr. Schoenfeld is affiliated with the University of California, San Francisco, and Dr. O’Malley is associated with the Uniformed Services University, Bethesda, Md. They had no financial conflicts to disclose.
Cutting down on unnecessary procedures allows primary care physicians to optimize their time with patients, and curbing routine glucose testing saves time and money, Adam J. Schoenfeld, MD, and Patrick G. O’Malley, MD, wrote in an editorial.
“Changing this policy to leave glucose testing to the discretion of the patient and nurse resulted in a decrease of 300 glucometer tests per month, saving the clinic $2, 000 and 25 hours of nursing time,” they wrote.
“Patients without infectious symptoms likely do not need their temperature taken, and we probably do not need to elicit a pain severity scale in patients without an active complaint of pain,” they noted. “Instead, other issues could take priority, such as medication reconciliation; collection of important psychosocial information, such as screening for commonly undiagnosed illnesses like depression; discussing advanced directives; and preparing the patient to be more active and engaged in addressing their agenda for the visit.”
Dr. Schoenfeld is affiliated with the University of California, San Francisco, and Dr. O’Malley is associated with the Uniformed Services University, Bethesda, Md. They had no financial conflicts to disclose.
Cutting down on unnecessary procedures allows primary care physicians to optimize their time with patients, and curbing routine glucose testing saves time and money, Adam J. Schoenfeld, MD, and Patrick G. O’Malley, MD, wrote in an editorial.
“Changing this policy to leave glucose testing to the discretion of the patient and nurse resulted in a decrease of 300 glucometer tests per month, saving the clinic $2, 000 and 25 hours of nursing time,” they wrote.
“Patients without infectious symptoms likely do not need their temperature taken, and we probably do not need to elicit a pain severity scale in patients without an active complaint of pain,” they noted. “Instead, other issues could take priority, such as medication reconciliation; collection of important psychosocial information, such as screening for commonly undiagnosed illnesses like depression; discussing advanced directives; and preparing the patient to be more active and engaged in addressing their agenda for the visit.”
Dr. Schoenfeld is affiliated with the University of California, San Francisco, and Dr. O’Malley is associated with the Uniformed Services University, Bethesda, Md. They had no financial conflicts to disclose.
Eliminating routine glucometer readings makes primary care visits more efficient, according to a 6-month review of activity at a primary care clinic. The results were published online Sept. 26 in JAMA Internal Medicine.
“The routine tasks that are components of rooming the clinic patient are increasing in number,” wrote James L Wofford, MD, of Wake Forest University, Winston-Salem, N.C., and his colleagues (JAMA Intern Med. 2016 Sep 26. doi: 10.1001/jamainternmed.2016.5769). Routine glucometer readings are costly in terms of time, money, and mental energy of clinicians, and do not add value, they wrote.
The researchers compared data from a primary care clinic in North Carolina for 3 months before and 3 months after the clinic eliminated routine glucometer readings (Jan. 1, 2015, to March 15, 2015, and March 16, 2015, to June 30, 2015). After a 1-week trial during which no routine clinical glucometry was performed, the option remained available at the request of a nurse or patient.
The number of glucometer readings decreased from approximately 400 per month to 100 per month after the change in policy, yielded a cost savings of at least $2,000 per month, and time saving of 25 hours of nursing time per month.
“Despite the fear of missing an occasional markedly elevated glucose level, clinicians gradually grew comfortable and never reconsidered reinstitution of routine glucometer readings,” Dr. Wofford and his associates wrote. However, some patient education was needed to reassure those who were disappointed by the change.
“As important as the lesson that routine glucometer readings in the clinic is a wasteful practice, the more important lesson is that examining office routines for foolish consistencies should be a regular component of making primary care more efficient,” the researchers added.
They had no financial conflicts to disclose.
Eliminating routine glucometer readings makes primary care visits more efficient, according to a 6-month review of activity at a primary care clinic. The results were published online Sept. 26 in JAMA Internal Medicine.
“The routine tasks that are components of rooming the clinic patient are increasing in number,” wrote James L Wofford, MD, of Wake Forest University, Winston-Salem, N.C., and his colleagues (JAMA Intern Med. 2016 Sep 26. doi: 10.1001/jamainternmed.2016.5769). Routine glucometer readings are costly in terms of time, money, and mental energy of clinicians, and do not add value, they wrote.
The researchers compared data from a primary care clinic in North Carolina for 3 months before and 3 months after the clinic eliminated routine glucometer readings (Jan. 1, 2015, to March 15, 2015, and March 16, 2015, to June 30, 2015). After a 1-week trial during which no routine clinical glucometry was performed, the option remained available at the request of a nurse or patient.
The number of glucometer readings decreased from approximately 400 per month to 100 per month after the change in policy, yielded a cost savings of at least $2,000 per month, and time saving of 25 hours of nursing time per month.
“Despite the fear of missing an occasional markedly elevated glucose level, clinicians gradually grew comfortable and never reconsidered reinstitution of routine glucometer readings,” Dr. Wofford and his associates wrote. However, some patient education was needed to reassure those who were disappointed by the change.
“As important as the lesson that routine glucometer readings in the clinic is a wasteful practice, the more important lesson is that examining office routines for foolish consistencies should be a regular component of making primary care more efficient,” the researchers added.
They had no financial conflicts to disclose.
FROM JAMA INTERNAL MEDICINE
Key clinical point: Routine glucometer readings are unnecessary as part of a primary care visit.
Major finding: Decreasing glucometer readings from approximately 400 per month to approximately 100 per month saved more than $2,000 and 25 hours of nursing time.
Data source: A comparison of 3 months before and after a policy change eliminating routine glucometer readings in a primary care clinic.
Disclosures: The researchers had no financial conflicts to disclose.
