Hospital care of people with diabetes needs dramatic improvement in order to decrease length of stay and improve safety and quality of the patient experience.

A 2017 analysis by Diabetes UK revealed that 260,000 inpatients with diabetes experienced a serious medication error.  Another 58,000 suffered a severe hypoglycemic incident due to incorrect insulin dosing.

In addition, hospitalized patients with diabetes have higher infection and mortality rates. They also have one to three days longer lengths of stay compared to people without diabetes.

As a result of this study results, Diabetes UK created a webpage and guidebook to improve care;  Making Hospitals Safe for People with Diabetes.

This Guidebook highlights six recommendations designed to improve quality of care for people in hospitals with diabetes.

1. Increase multidisciplinary diabetes inpatient teams – teams should include a diabetes consultant, diabetes nurse, dietitian, pharmacists and other specialists who meet regularly and have administrative support. 

2. Strong clinical leadership from diabetes inpatient teams – the teams that consistently show resilience, courage and influence, were most likely to drive change and quality improvement.

3. Knowledgeable healthcare professionals who understand diabetes– people with diabetes should feel safe in the hospital setting. All healthcare staff need diabetes training to provide the best care possible.

4. Better support in hospitals for people to take ownership of their diabetes – encourage patients to take more ownership of their diabetes self-care in the hospital setting to build confidence and help prepare for a safe discharge.

5. Better access to systems and technology – have systems in place to identify inpatients with diabetes, prevent prescribing errors and make sure the patient has been provided with instruction for a safe discharge. These systems should also track re-admissions as a result of unstable diabetes control.

6. More support to help hospitals learn from mistakes – determining the causes of errors and the steps to prevent them from happening in the future will improve care. More support is needed to collect and share data, so that mistakes can be identified and fixed.

Although this report comes from the other side of the pond, U.S. hospitals are struggling with similar issues. Current stats reveal that about 20% of people in U.S Hospitals have diabetes. According to National Diabetes Statistics Report, 2017 from the CDC, a total of 7.2 million hospital discharges were reported with diabetes as any listed diagnosis among U.S. adults aged 18 years or older in 2014. 

The six steps listed above provide an excellent framework to make improvements in hospitals and provide the very best inpatient diabetes care in the U.S. and internationally.

• Download Making hospitals safe for people with diabetes (PDF, 1091KB)
• Download our Self-assessment checklist for hospitals (PDF, 45KB)
• Enjoy our Hospital and Hyperglycemia Resource Page

submitted by Beverly Thomassian, RN, MPH, CDCES, BC-ADM
Diabetes Nurse Specialist and President, Diabetes Education Services

To learn more, enjoy our Level 2 – Hospital and Hyperglycemia 1.5 CEs

Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge.  This course reviews the evidence that supports inpatient glucose control and outline practical strategies to achieve targets in the inpatient setting.  We incorporate the latest ADA Standards and provide links to resources and inpatient management templates.

This course is included in: Level 2 – Beyond Fundamentals. Purchase this course individually for $29 or the entire bundle and save 70%.