Hospital project transforming care for diabetes patients

DrMayankPatel

Doctors, nurses and pharmacists in Southampton are transforming the way diabetes sufferers are cared for during their time in hospital.

In a three-month pilot project led by Dr Mayank Patel, lead consultant in diabetes at Southampton General Hospital, almost 400 cardiac, orthopaedic and vascular patients with the condition were seen in daily ‘bedside clinics’ by an inpatient diabetes team.

Although around 15% of all inpatients at University Hospital Southampton NHS Foundation have diabetes, they would previously have only been seen on a reactive basis once referred by their ward.

“With only one specialist diabetes nurse and one part-time diabetes dietitian working with a consultant and pharmacist who had to split diabetes work with other general medicine duties before the launch of this project, the experience for patients with diabetes was poor and that needed to change,” said Dr Patel.

“By switching the focus onto caring for patients’ diabetes before they encounter problems and allowing us to dedicate time to them and the staff treating them, we have seen quite a radical transformation.”

The 2012 National Diabetes Inpatient Audit found 3,700 patients in hospitals across England and Wales experienced at least one medication error in one week, with those affected suffering double the number of severe hypoglycaemic episodes – a drop in blood sugar levels which can cause seizures and lead to coma.

The audit followed concerns raised by Dr Gerry Rayman, national clinical lead for inpatient diabetes, that many patients were receiving “inadequate” diabetes care in NHS hospitals, with one in three operating with no dedicated specialist nurse.

As part of the full-time project in Southampton, the diabetes team, made up of a consultant, two specialist nurses, a research dietitian and a pharmacist, completed full daily reviews, which included foot examinations, provided information materials to all patients and staff, offered bespoke teaching sessions to all wards and rectified any unsafe or incorrect prescribing.

In addition to preventing 45 potential diabetes-related medication errors, reducing readmission rates from 8.91% to 5% and reducing the length of inpatient stay – a yearly saving of £200,000 – all patients surveyed said they were satisfied with their overall diabetes care, including the number of visits, clarity of information and monitoring of their condition.

Dr Patel added: “As a diabetes specialist team, it is our aim to ensure that the condition is managed just as well as a patient’s heart or orthopaedic surgery while they are under our care and we are making great strides in moving diabetes up the agenda here in Southampton.”

Following the pilot, which was recently named one of the best inpatient care initiatives of the year at the Quality in Care Diabetes Awards, planning is underway to extend this project to cover the stroke unit and surgical wards.

Anyone interested in finding out more about the project or the condition is invited to an open evening with Dr Patel and his team at Central Hall in Southampton on Monday, 19 November from 7pm to 9pm. To book a place, email UHSmember@uhs.nhs.uk or call 023 8120 4853.

Posted on Monday 22 October 2012