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QJM Advance Access published online on January 18, 2009
QJM, doi:10.1093/qjmed/hcn174
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The effectiveness of a hospital diabetes outreach service in supporting care for acutely admitted patients with diabetes

R. Mahto, H. Venugopal, V. S. Vibhuti, A. Mukherjee, V. Cherukuri, B. Healey, V. Baskar, H. N. Buch and B. M. Singh

Wolverhampton Diabetes Centre, New Cross Hospital, Wolverhampton, WV10 0QP, UK

Address correspondence to Dr Rajni Mahto, MD, MRCP, Wolverhampton Diabetes Centre, New Cross Hospital, Wolverhampton, WV10 0QP. email: rajnimahto{at}yahoo.com

Received 5 August 2008 and in revised form 1 December 2008


  Abstract

Background: Patients with diabetes have increased frequency of hospital admissions and longer lengths of stay compared to patients without diabetes. Our specialist diabetes inpatient service was reconfigured to deliver a proactive diabetes outreach service to improve the overall care of this population.

Aims: To ascertain the effect of a structured diabetes outreach service to acutely admitted patients with diabetes on avoidable admissions, delayed discharges and appropriate diabetes related follow-up plans.

Methods: Audits were carried out before and 4 months after the introduction of a diabetes outreach service. The proportion of patients under care of the diabetes team, avoidable admissions, delayed discharges and existence of effective follow-up plans were compared pre- and post-implementation of this outreach service.

Results: The number of inpatients with diabetes fell by 35% (83 on a typical day pre-outreach vs. 53 post-outreach) despite a similar number of total medical admissions in that month (1449 vs.1459). This was due to a reduction in those admitted with diabetes related (13 vs. 5) and general medical (29 vs. 10) problems whilst numbers requiring other specialist care (41 vs. 39) remained unchanged. The proportion of patients under the care of diabetes team rose (23% vs. 73%) while those with avoidable admissions (18% vs. 7%), delayed discharges (17% vs. 2%) and inappropriate discharge plans (65% vs. 11%) all fell.

Conclusions: This reformatted service was associated with a marked improvement in a number of parameters relevant to inpatient care.


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