Increasing numbers of patients with diabetes are attending Dandenong Hospital and specifically the Emergency Department (ED), many requiring a hospital admission. To ensure prompt follow-up post discharge from hospital, the Nurse Practitioner (NP) led Diabetes Fast Track Clinic (FTC) provides timely management, advanced care planning and transition into appropriate community services for ongoing care.

Aims: To assess the clinical impact of the FTC by focusing on improvements in glycaemic control, effectiveness in reaching target clientele and ensuring alignment of the NP role with key unit and organisational goals and priorities.

Methods:  A retrospective audit of medical records for patients who were scheduled to attend the NP Diabetes FTC from 1 November 2013 to 31 May 2014 was conducted.  A data collection template was designed and patient information was de-identified and collated into an excel spread sheet for analysis. Quantitative statistics were generated from the data to summarise the number of patients seen and descriptive characteristics.

Results: Of the 51 people and 114 patient appointments scheduled for the Diabetes FTC, 37 people (70%) attended and 16 people (30%) failed to attend. Glycaemic control, as determined by HbA1c, pre and post FTC attendance showed improvement in most cases. However, there was considerable lag time between discharge from hospital and first FTC appointment. Most referrals to FTC were from Monash Health specialists and the average number of visits to the FTC was three. The majority of patients were discharged back to their General Practitioner for ongoing management, a small proportion onto specialist care which could be private or public and at the time of the audit 24% of patients remained in the FTC service.  

Conclusions: Closing the gap to timely follow-up remains a priority consideration. The audit has shown a benefit to this patient population and has highlighted areas that can be improved to ensure an effective and efficient service model.