Improving clinical diabetes care
DIABETES CREATES COMPLICATIONS DURING HOSPITALISATION
Between 20 and 25% of patients who are hospitalised also suffer from diabetes, even though this is not the reason for their hospital stay. Managing diabetes in hospitals is a complex process, one that is frequently overlooked by staff. A neglect of diabetes in patients tends to create complications: there is an increase in the number of wound infections, mortality rates rise, and hospital stays are longer than strictly necessary. This hospital wanted to end this situation and improve diabetes care for clinical patients.
WORKING CLOSELY WITH THE CLIENT
We set up a diabetes team in conjunction with diabetes specialists, diabetes nurses and one doctor-in-training. This team screens all patients admitted to the hospital on a daily basis for diabetes and their risk of deregulation using a list generated by the EPF system. The team advises the department on a proactive basis where necessary, and in some cases a nurse might visit the patient to prescribe or adjust their medication. In order to achieve this, we worked with the client on developing the work process in detail, adjusting protocols where necessary, defining roles and responsibilities, and working on building the team. We also created a digital tool to be used in the screening process. Diabetes patients are identified based on an algorithm, after which they are assigned a risk score. We tested the new process and tools as part of a pilot project in one of the clinical departments.
EFFECTIVE EVERYDAY CLINICAL DIABETIC CARE
The pilot project turned out to be highly successful: patients with diabetes were identified who would not have received the highest-quality diabetes care without the support of the diabetes team. In addition, it was noted that diabetes received more attention from healthcare professionals and that the proactive policy reduced deregulation of diabetes patients. It is expected that a portion of patients will have to spend less time in the hospital, thereby saving four beds on an annual basis. The successful results of the pilot project provided an incentive to extend the diabetes team to elsewhere in the hospital. The client told us that they ‘never thought they would be able to achieve so much’. In other words, mission accomplished!