Health & Education

Tribal Clinic keys in on diabetes care

03.31.2011 TJ McKnight Health & Wellness

By Jennifer Leggett

Tribal Nurse Supervisor

We hear in the news almost every day about the problems with health care and the increasing prevalence of diabetes.

The Health and Wellness Center also has been thinking about these things and how we can make an impact for the positive. Beginning with the 2010 year, the Grand Ronde registered nurses took on some new duties. Their job description is no longer to only triage medical concerns, but also to "case manage" our diabetic population.

Clinic staff hoped that this approach would both improve health outcomes and help provide a personal touch, strengthening our bond with the community.

 The registered nurses spent weeks combing through the records of our patients and began placing the active clinic user with diabetes on a diabetic register. Once the register was populated, they began the process of reviewing their care.

The goal was to improve the rate of compliance by the patient and the clinic with two targeted standards of care outlined by the American Diabetes Association and the Indian Health Service.  Those being the annual testing of cholesterol and blood pressure control.

These topics were chosen because of the significant correlation between diabetes and heart disease. The Indian Health Service factsheet on diabetes indicates that the rate of developing heart disease is three to four times higher than for those without diabetes. And heart disease continues to be the No.  1 reason for death year after year in the Indian health care statistics.

Below is an excerpt from our 2010 Quality Improvement study. We hope that you find this both as informative and positively affecting our community.


Baseline 2009 Diabetes Audit

1st Q.

2nd Q.

3rd Q.

4th Q.

Cholesterol screening






 BPs equal to or less than  130/80






As you can see, there has been a significant improvement in the care of diabetics who receive their primary care at the clinic. While the blood pressure control did decline in the winter months, we did see an improvement for three quarters of the year exceeding the national standard. We are expecting that to rebound after the winter cold and flu season is past.

The Tribal Clinic will continue to work this method as it has shown to be beneficial, and we hope to bring you more good news about other aspects of our efforts to improve the health of our community.