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Table 2 Sample chart review tool from session on diabetes mellitus type 2

From: Implementation of a novel population panel management curriculum among interprofessional health care trainees

Chronic disease data

Patient A data

Patient B data

Patient Identifier

  

Date of Last visit

  

Age

  

Comorbidities (Coronary Artery Disease, Stroke, Hypertension)

  

Tobacco

  

Hemoglobin A1c / date

  

Medications

  

Medications refilled as expected?

  

Last blood pressure / date

  

Body Mass Index

  

Urine microalbumin / date

  

LDL cholesterol / date

  

Dilated retinal exam result / date

  
  1. Write three observations for improvement: 1 2 3