Diabetes care in hospital—the impact of a dedicated inpatient care team

Aims  At any given time, people with diabetes occupy approximately 5–10% of acute hospital beds. In addition, diabetes is associated with a greater length of stay (LOS). This is partially because of increased complexity of the cases but also because of unfamiliarity of dealing with the condition by other specialist teams. Methods  In 2002, with increasing pressure on acute hospital beds, a team was established to improve the care of inpatients with diabetes admitted to Derriford Hospital. The team consisted of five diabetes specialist nurses dedicated to inpatient care, supported by a consultant and specialist registrar diabetologist. A link nurse responsible for diabetes was appointed on every ward and each individual with a diagnosis of diabetes was identified on admission. We have compared LOS of all patients with diabetes admitted between January 2002 and December 2006. Results  LOS fell from a mean ± se of 8.3 ± 0.18 days in 2002 to 7.7 ± 0.10 days in 2006 (P = 0.002). Significant falls were seen for emergency admissions (9.7 ± 0.23 vs. 9.2 ± 0.20, P < 0.001) but not elective admissions. The data show significant reductions in LOS for medical admissions (9.2 ± 0.24 vs. 8.4 ± 0.20, P < 0.001) but not surgical admissions. Over the same period, LOS for the total hospital population fell by 0.3 days (P < 0.001). Conclusion  In conclusion, a team specifically employed to focus on inpatient diabetes care has a significant impact on LOS of this patient group.