Ambulatory Insulin Stabilisation Service: Patient Participation Post-implementation of Improvement Strategies — ASN Events
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Ambulatory Insulin Stabilisation Service: Patient Participation Post-implementation of Improvement Strategies (#398)

Katie Marley 1 , Wayne Dawson 1 , Emily Hill 1 , Felicity McManus 1 , Catherine Thien 1 , Joshua Tsan 1
  1. The Royal Melbourne Hospital, Parkville, VIC, Australia

Introduction

Following on from a program evaluation in 20111 that examined patient participation, we implemented a number of improvement strategies.  This abstract reports a second evaluation of our Ambulatory Insulin Stabilisation Service. 

Objectives

The main objective was to compare the two evaluations and identify measures that may be key to running a more successful service.  Other aims were to demonstrate increased patient participation over time, improved coordination of the service, ongoing monitoring and documentation of participation and improved clinical documentation.

Methods

This evaluation compares activity statistics collected May – November 2011 with the same time period in 2014, following implementation of improvement strategies.  ‘Non-Participation’ was defined as the patient never having made contact with the service.  'Participation' was defined at the patient having made at least one contact with the service beyond any follow-up phonecalls initiated by the Diabetes Nurse Educator.

Results 

In May – November 2011, 160 referrals were received compared with 176 in May – November 2014.  After implementation of the improvement strategies, participation increased from 77 (48%) in 2011, to 163 (93%) in 2014. 

Conclusions

Implementation of the improvement strategies saw participation and retention rates increase.  Referrers report satisfaction with the service and a reduction in patient complaints.  Increased referral and participation numbers could be interpreted as improved referrer/patient satisfaction and confidence in the service.   

Key improvement strategies included:

- Designation of program leads, including Administration Support and Diabetes Nurse Educator staff; to drive the program and improvement strategies

- A protocol from referral to discharge, including 2 follow-up calls initiated by the Diabetes Nurse Educator before discharge for non-participation

- A shared active electronic spreadsheet monitoring referrals and documenting participation

- Monthly audits

- Workflow across the administration and educator teams

- Consistent clinical documentation

  1. Dawson, W, Bowden, J, Colman, P, Marley, K, Palmer, K, Thien, C (2012) Outpatient Insulin Stabilisation - A Review of Service Utilisation at Melbourne Health. Abstract Presentation at ADS/ADEA Annual Scientific Meeting, Gold Coast Convention and Exhibition Centre