Objective: To standardize insulin prescribing practices for inpatients, improve management of hypoglycemia, reduce reliance on sliding scales, increase use of basal-bolus insulin and improve patient safety.
Methods: Patients with diabetes were admitted to 2 pilot inpatient units followed by corporate spread to all insulin-treated patients on noncritical care units in a Canadian tertiary care multicampus teaching hospital. Standardized preprinted insulin and hypoglycemia management orders, decision support tools and multidisciplinary education strategies were developed, tested and implemented by way of the Model for Improvement and The Ottawa Model for Research Process.
Objective: Many people with dysglycemia are unaware that they have the condition. We conducted a study to determine whether a screening program for hospitalized patients could identify new cases of unrecognized dysglycemia and affect the actions of attending care providers during hospitalization.
Methods: We measured A1C in 466 participants with no history of diabetes who had been admitted to hospital for coronary heart disease or elective joint replacement surgery.
The epidemic of diabetes has increased pressure on the whole spectrum of the healthcare system including specialist centres. The authors' own specialist centre at The Ottawa Hospital has 20,000 annual visits for diabetes, 80% of which are follow-up visits. Since it is a tertiary facility, managers, administrators and clinicians would like to increase their ability to see newly referred patients and decrease the number of follow-up visits.
View Article and Find Full Text PDFBackground: The growing prevalence of diabetes and heightened awareness of the benefits of early and intensive disease management have increased service demands and expectations not only of primary care physicians but also of diabetes specialists. While research has addressed issues related to referral into specialist care, much less has been published about the transition from diabetes specialists back to primary care. Understanding the concerns of family physicians related to discharge of diabetes care from specialist centers can support the development of strategies that facilitate this transition and result in broader access to limited specialist services.
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