Helping Diabetic Patients Achieve Glycemic Control: Barriers to the Transition of Care from an Inpatient to Outpatient Setting

Abstract

Problem: Achieving glycemic control in patients with diabetes can be a challenging task. This is especially true when patients become ill and require admission to an acute care facility, and subsequent discharge. The transition of care between the inpatient and outpatient setting can be difficult to navigate, for patients and providers, and can result in poor blood glucose control as well as other complications.|Purpose: The purpose of this study is to identify barriers to the transition of care for patients with diabetes from the inpatient to outpatient setting.|Subjects: Hospitalist and primary care providers practicing at an integrated health system in a Midwest community.|Methods: Hospitalist and primary care providers were surveyed to identify if barriers exist in the transition of care and if so, what specific barriers they have identified. The 16 question survey using BlueQ, a survey program through Creighton University, was emailed to the providers at two intervals, initial and again at two weeks. Participation was voluntary and completion of the survey acted as consent.|Results: Of the 90 surveys that were sent out, a total of 7 responses were received and included five MDs, one DO and one nurse practitioner. All of the survey respondents strongly agreed that the transition of care between the inpatient and outpatient setting is important for patients with diabetes. All of the providers agreed (85.7%) or strongly agreed (14.3%) that barriers exist in the transition of care. All respondents either strongly agreed (43%) or agreed (57%) that use of a discharge coordinator or team would help improve the process of discharge transition for patients with diabetes. Suggested improvements to the transition of care included better communication and a more proactive role of diabetes educators and health coaches in discharge planning and patient education. In addition, a timely follow up appointment with the primary care provider was recommended.Title: Helping Diabetic Patients Achieve Glycemic Control: Barriers to the Transition of Care from an Inpatient to Outpatient Setting Problem: Achieving glycemic control in patients with diabetes can be a challenging task. This is especially true when patients become ill and require admission to an acute care facility, and subsequent discharge. The transition of care between the inpatient and outpatient setting can be difficult to navigate, for patients and providers, and can result in poor blood glucose control as well as other complications. Purpose: The purpose of this study is to identify barriers to the transition of care for patients with diabetes from the inpatient to outpatient setting. Subjects: Hospitalist and primary care providers practicing at an integrated health system in a Midwest community. Methods: Hospitalist and primary care providers were surveyed to identify if barriers exist in the transition of care and if so, what specific barriers they have identified. The 16 question survey using BlueQ, a survey program through Creighton University, was emailed to the providers at two intervals, initial and again at two weeks. Participation was voluntary and completion of the survey acted as consent. Results: Of the 90 surveys that were sent out, a total of 7 responses were received and included five MDs, one DO and one nurse practitioner. All of the survey respondents strongly agreed that the transition of care between the inpatient and outpatient setting is important for patients with diabetes. All of the providers agreed (85.7%) or strongly agreed (14.3%) that barriers exist in the transition of care. All respondents either strongly agreed (43%) or agreed (57%) that use of a discharge coordinator or team would help improve the process of discharge transition for patients with diabetes. Suggested improvements to the transition of care included better communication and a more proactive role of diabetes educators and health coaches in discharge planning and patient education. In addition, a timely follow up appointment with the primary care provider was recommended