The discharge of patients with diabetes from Internal Medicine Units: a clinical audit

  • Andrea Montagnani | montagnaniand@gmail.com Internal Medicine Unit, Misericordia Hospital, Grosseto, Italy.
  • Laura Morbidoni Internal Medicine Unit, Senigallia Hospital, Senigallia (AN), Italy.
  • Tiziana Attardo Internal Medicine Unit, B. Lombardo Hospital, Canicattì (AG), Italy.
  • Davide Brancato Internal Medicine Unit, Civic Hospital, Partinico (PA), Italy.
  • Maurizia Gambacorta Internal Medicine Unit, Media Valle del Tevere Hospital, Todi (PG), Italy.
  • Alberto Grassi Internal Medicine Unit, Infermi Hospital, Rimini, Italy.
  • Ada Maffettone Internal Medicine Unit, Colli Hospital, Napoli, Italy.
  • Roberta Re Internal Medicine Unit, Maggiore della Carità Hospital, Novara, Italy.
  • Daniela Tirotta Internal Medicine Unit, Cattolica Hospital, Rimini, Italy.
  • Mauro Campanini Internal Medicine Unit, Maggiore della Carità Hospital, Novara, Italy.
  • for the FADOI Permanent Area of Clinical Governance

Abstract

The aim of the present study was to address it by conducting a clinical audit, one that focused on the quality evaluation of the assistance given to patients with diabetes at the moment of their discharge from hospital. The clinical audit was structured in 5 phases: i) preparation; ii) definition of criteria, indicators and standards; iii) retrospective data collection; iv) data analysis, identification of main deviations from standards; v) implementation of corrective measures. Twenty Departments of Internal Medicine from 10 Italian regions retrospectively reviewed medical reports obtaining a data collection from 1332 discharged patients with diabetes. Patients receiving instructions for home glycemic control/discharged patients, showed a mean performance =41.6% (range: 5.0-89.9); patients receiving instructions for hypoglycemic treatment/discharged patients, =32.4% (range: 0.0-92.1); patients receiving instructions for subcutaneous insulin administration/discharged patients, =60.4% (range: 56.5-100.0); patients receiving nutritional scheme or advice/discharged patients, =24.8 (range: 25.4-76.6); patients addressed to ambulatory control/discharged patients, =60.7% (range: 65.6-100.0); and finally patients with HbA1c reported in discharge report/discharged patients, =40.6% (range: 1.75-98.0). Results confirmed that all the levels are well below 70%, the acceptable level of quality. The clinical audit provided data that allows for better identification of deficient clinical behaviors and the addressing of them with specific ameliorative actions; a continuing process of check, re-check and feedback in order to further enhance the quality of assistance given to patients with diabetes discharged from hospital.

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Published
2015-05-08
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Original Articles
Keywords:
Diabetes, hospital discharge, clinical audit, quality.
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How to Cite
Montagnani, A., Morbidoni, L., Attardo, T., Brancato, D., Gambacorta, M., Grassi, A., Maffettone, A., Re, R., Tirotta, D., Campanini, M., & of Clinical Governance, for the F. P. A. (2015). The discharge of patients with diabetes from Internal Medicine Units: a clinical audit. Italian Journal of Medicine, 9(2), 141-149. https://doi.org/10.4081/itjm.2015.486