title: The effectiveness of a hospital diabetes outreach service in supporting care for acutely admitted patients with diabetes.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Wolverhampton Diabetes Centre, New Cross Hospital, Wolverhampton. rajnimahto@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Mahto
authors.forename: H
authors.initials: H
authors.lastname: Venugopal
authors.forename: V S
authors.initials: VS
authors.lastname: Vibhuti
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: V
authors.initials: V
authors.lastname: Cherukuri
authors.forename: B
authors.initials: B
authors.lastname: Healey
authors.forename: V
authors.initials: V
authors.lastname: Baskar
authors.forename: H N
authors.initials: HN
authors.lastname: Buch
authors.forename: B M
authors.initials: BM
authors.lastname: Singh
mesh_terms: D000368:Aged; D003266:Continuity of Patient Care / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D010353:Patient Education as Topic; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards*