Diabetes
Conditions
Keywords
Inpatient Diabetes Management, Prevent <31 day readmission in patients with Diabetes, CDEs role in transition of care of inpatients with diabetes
Brief summary
The purpose of this study is to assess whether intensive case management interventions by a diabetes team, led by an endocrinologist and certified diabetes educator, can prevent \<31 day readmission in previously identified high risk patients with diabetes.The procedures of the study will focus on managing the patient's diabetes and diabetes education while in the hospital, decreasing the patient's risk for hypoglycemia and hyperglycemia in the hospital, and assist in the patient's diabetes management plan for a safe discharge.
Interventions
OTHERIntensive Diabetes Case Management
A diabetes team , led by an endocrinologist and CDE, will manage the patients diabetes while in the hospital and will assist with the patient's discharge Diabetes endocrine consult team will manage the patient's diabetes daily while in the hospital Discharge diabetes medication reconciliation per research team Research team will provide 30 day supply of diabetes medication/supplies at discharge Research Team will provide 30 day supply of glucose test strips at discharge Discharge telecommunication from endocrinologist to primary care provider Patient-centered discharge diabetes education per research CDE Post-discharge 48-72 hours continuity check per phone by a diabetes research team member/CDE \--------------------------------------------------------------------------------
Sponsors
Barnes-Jewish Hospital
Washington University School of Medicine
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients admitted with a diagnosis of diabetes, Patients with a previous history of Pharmacy Expert System (PES) alert, Enrollment in research must be within 24 hours of admission
Exclusion criteria
* Patients transferred from institutionalized care, Patients who already plan to move to institutionalized care, Patients with severe co-morbidities (e.g. terminal cancer), Patients admitted for surgery within 24 hours, Patients who are unwilling or unable to give written consent (e.g. dementia), Patients who are homeless, Patients previously admitted to the diabetes endocrine service
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevent <31 day readmission | The length of time between hospital discharge and readmission 31 days | Primary outcome measure is to assess whether an intensive case management intervention by a diabetes team, led by an endocrinologist and a certified diabetes educator (CDE) , can prevent a \<31 day readmission in previously identified high risk patients with diabetes compared to standard/usual care. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| improve overall glycemic management | Upon the participant's consent (within 24 hours of hospital admission) to hospital discharge- the average length of stay is five days | To examine whether intensive case management intervention per endocrinologist and CDE during hospital stay prevents hypoglycemia \<70mg/dl, severe hypoglycemia \<40mg/dl, and improves overall glycemic management (100-180 mg/dl) compared to standard/usual care. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | From the time of consent (within 24 hours of admission) to the time of discharge- the average length of stay is 5 days. | to assess whether intensive case management intervention by a diabetes team , led by an endocrinologists and a CDE, can improve patient's overall satisfaction. The research participant will be given a brief satisfaction questionaire at the time of discharge. |
Countries
United States
Outcome results
None listed