• 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. rajnimahto@yahoo.com
• QJM. 2009 Mar 1; 102 (3): 203-7.

BackgroundPatients 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.AimsTo 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.MethodsAudits 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.ResultsThe 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.ConclusionThis reformatted service was associated with a marked improvement in a number of parameters relevant to inpatient care.

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