The Endocrine Hospitalist: Enhancing the Quality of Diabetes Care

2021 ◽  
pp. 193229682110079
Author(s):  
Mihail Zilbermint
Keyword(s):  
Hospital Readmission ◽  
Community Hospital ◽  
Diabetes Management ◽  
Healthcare Systems ◽  
Inpatient Diabetes ◽  
Start Up ◽  
Quality Of Diabetes Care ◽  
Fellowship Programs ◽  
Inpatient Diabetes Management

The endocrine hospitalist and inpatient diabetes management team increases access to endocrinology consultations and improves glycemic control and quality metrics such as length of stay and hospital readmission. Enhanced glycemic care is needed in both academic and community hospital settings. Endocrine fellowship programs should implement endocrine hospitalist rotations with emphasis on training endocrine fellows to deliver fast-paced inpatient endocrine care. Entrepreneurship, innovation, and a “start-up” culture within the field of Endocrinology should be encouraged and supported by healthcare systems.

scholarly journals Effects of a Dedicated Inpatient Diabetes Management Service on Glycemic Control in a Community Hospital Setting

2021 ◽  
pp. 193229682199319
Author(s):  
Andrew P. Demidowich ◽  
Kristine Batty ◽  
Teresa Love ◽  
Sam Sokolinsky ◽  
Lisa Grubb ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Community Hospital ◽  
Diabetes Management ◽  
Hospital Setting ◽  
The United States ◽  
Cost Of Care ◽  
Management Service ◽  
Full Time ◽  
Inpatient Diabetes ◽  
Inpatient Diabetes Management

Background: Community hospitals account for over 84% of all hospitals and over 94% of hospital admissions in the United States. In academic settings, implementation of an Inpatient Diabetes Management Service (IDMS) model of care has been shown to reduce rates of hyper- and hypoglycemia, hospital length of stay (LOS), and associated hospital costs. However, few studies to date have evaluated the implementation of a dedicated IDMS in a community hospital setting. Methods: This retrospective study examined the effects of changing the model of inpatient diabetes consultations from a local, private endocrine practice to a full-time endocrine hospitalist on glycemic control, LOS, and 30-day readmission rates in a 267-bed community hospital. Results: Overall diabetes patient days for the hospital were similar pre- and post-intervention (20,191 vs 20,262); however, the volume of patients seen by IDMS increased significantly after changing models. Rates of hyperglycemia decreased both among patients seen by IDMS (53.8% to 42.5%, P < .0001) and those not consulted on by IDMS (33.2% to 29.9%; P < .0001). When examined over time, rates of hypoglycemia steadily decreased in the 24 months after dedicated IDMS initiation ( P = .02); no such time effect was seen prior to IDMS ( P = .34). LOS and 30DRR were not significantly different between IDMS models. Conclusions: Implementation of an endocrine hospitalist-based IDMS at a community hospital was associated with significantly decreased hyperglycemia, while avoiding concurrent increases in hypoglycemia. Further studies are needed to investigate whether these effects are associated with improvements in clinical outcomes, patient or staff satisfaction scores, or total cost of care.

scholarly journals Changing diabetes® barometer: A global quality monitoring framework for improving patient outcomes

2013 ◽  
Vol 01 (01) ◽  
pp. 044-047
Author(s):  
Pavika Jain ◽  
Niels Aamand
Keyword(s):  
Quality Of Care ◽  
Patient Outcomes ◽  
Diabetes Care ◽  
Best Practice ◽  
Diabetes Management ◽  
Global Perspective ◽  
Quality Monitoring ◽  
Good Practices ◽  
Quality Of Diabetes Care

This article has a global perspective and includes examples from several continents i.e. Latin America, Africa, Asia and Europe. The Changing Diabetes® Barometer (CDB) is a Novo Nordisk initiative that works as a worldwide quality monitoring system for diabetes management to measure the gains made in the fight against diabetes focusing on quality of care and patient outcomes. CDB provides a platform for countries to share local diabetes data and good practices. In doing so it aims to disseminate improved practices of care. CDB is conceptualised as a framework that can help change diabetes. Its three cornerstones are “Measure, Share, Improve” (MSI):• MEASURE the quality of diabetes care through patient outcomes and care processes.• SHARE data on the quality of diabetes care and good practices with all relevant stakeholders.• IMPROVE the quality of diabetes care by identifying and actively spreading good practices in diabetes care and inspire others to adopt and follow best practice examples.Italy and Algeria both constitute best practice examples of CDB initiatives. In Italy a registry solution is already solidly implemented and improvements in patient outcomes have been documented. The initiative in Algeria has recently been initiated including establishment of IT equipment in participating clinics to ensure all relevant measurements. This will enable transparency on current level of quality of diabetes care. Both initiatives have the common goal of driving improvements in quality of care and patient outcomes across clinics. India is another good example where data is collected through the CDB aimed at driving improvement of diabetes care in order to improve quality of life for people with diabetes. CDB in India is implemented in five states (Goa, Bihar, Gujarat, Puducherry and Andhra Pradesh) and is planned to be expanded to five additional states.

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