Therapeutic inertia in diabetes management is the failure to initiate or intensify pharmacological treatment when a patient's glycated hemoglobin (HbA1c) goals are not met. Studies have shown that primary care providers (PCPs) overestimate how aggressive they are at titrating glucose-lowering therapy and that they underestimate how long their patients' HbA1c remain above goal. Early and more aggressive management of hyperglycemia reduces long term microvascular and macrovascular complications. Reducing therapeutic inertia leads to improved patient outcomes. The primary aim of this quality improvement project was to decrease the percentage of patients age 18-75 years with HbA1c >9% who had no diabetic medication changes at their last visit by 10% at a primary care clinic in the Pacific Northwest.