Download: Summary Success Story (PDF 175KB) / Full Success Story (PDF 156KB)

The challenge:

Following a pilot scheme run in 2002, the diabetes team at Plymouth Hospitals identified that more could be done to reduce the lenght of time people with diabetes spent in hospital following emergency and planned admissions. They wanted to speed up the time it took to identify people with diabetes and put appropriate care in place.

The aim:

There were three main aims of the project:

• to increase hospital staff’s awareness of diabetes and expertise in its management
• to prevent diabetes related morbidity in inpatients
• to troubleshoot any diabetes problems throughout the hospital

What did they do?

After making a business case to the trust management, funding was approved to appoint three whole time equivalent diabetes specialist nurses (DSNs) Each nurse was responsible for specific wards in the hospital. The DSNs identified a link nurse on each of their nominated wards with whom they could work to improve identification of diabetes and discuss any other diabetes care issues. The DSNs visited their nominated wards every day to identify any newly admitted patients with diabets and ensure their care is appropriate.

Additionally the team, which also includes a consultant and registrar diabetologists, ran a rolling education programme for hospital staff to increase awareness of diabetes and improve knowledge of diabetes management. The team also produced updated protocols and pathways to improve the management of specific aspects of diabetes care.

What happened?

Over the four year study period lengths of stay fell from a mean of 8.3 days in 2002 to 7.7 days in 2006, a reduction of 0.6 days. Significant falls in length of stay were seen for emergency admissions (9.7 days to 9.2 days - by 0.5 days) but not elective surgical admissions – however a second project was set up to tackle this which is also the subject of a ‘success story’. In contrast the length of stay for the total hospital population fell by 0.3 days.