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多方位措施改善一家三甲医院的住院糖尿病治疗。

A multi-faceted approach improves inpatient diabetes care at a tertiary hospital.

机构信息

Department of Diabetes and Metabolism, The Royal London Hospital, Barts Health NHS Trust, London, UK.

Aberfeldy Practice, London, UK.

出版信息

Br J Hosp Med (Lond). 2022 Jul 2;83(7):1-5. doi: 10.12968/hmed.2022.0078. Epub 2022 Jul 6.

Abstract

BACKGROUND/AIMS: The results of the National Diabetes Inpatient Audit in 2013 showed that the Royal London Hospital had performed worse than the national average in several domains. The aim of this study was to improve inpatient diabetes care at the Royal London Hospital.

METHODS

A multi-faceted intervention was designed via a Commission for Quality and Innovation workstream which spanned from April 2014 to March 2016. The National Diabetes Inpatient Audit results of 2013, 2016 and 2019 were compared to look at the outcomes and analyse the changes brought about by the intervention.

RESULTS

There were statistically significant improvements in medication errors, prescription errors, glucose management errors and insulin errors in 2016 and 2019 as compared to 2013. More inpatients with diabetes were visited by the diabetes team, received foot assessment and patient feedback improved in both 2016 and 2019 as compared to 2013.

CONCLUSIONS

A multi-faceted approach led to significant improvements in patient outcomes and experience, resulting in Royal London Hospital performing well above the national average in the National Diabetes Inpatient Audit in 2016 and 2019. This simple consultant-led multidisciplinary approach could be replicated in other hospitals in UK facing similar challenges.

摘要

背景/目的:2013 年全国糖尿病住院患者审核结果显示,伦敦皇家医院在多个领域的表现均逊于全国平均水平。本研究旨在改善伦敦皇家医院的住院糖尿病患者护理。

方法

通过质量与创新委员会的一个工作组设计了多方面的干预措施,该工作组从 2014 年 4 月至 2016 年 3 月开展工作。比较 2013 年、2016 年和 2019 年全国糖尿病住院患者审核结果,观察结果并分析干预带来的变化。

结果

与 2013 年相比,2016 年和 2019 年在药物错误、处方错误、血糖管理错误和胰岛素错误方面有统计学显著改善。与 2013 年相比,接受糖尿病团队访视、足部评估以及患者反馈有所改善的糖尿病患者更多。

结论

多方面的方法显著改善了患者的预后和体验,使伦敦皇家医院在 2016 年和 2019 年全国糖尿病住院患者审核中表现优于全国平均水平。这种由顾问主导的简单多学科方法可以在英国其他面临类似挑战的医院中复制。

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