SHM Converge Scientific Abstract ePoster Gallery-Insights on Insulin Discharge Practices

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This survey-based study examined insulin discharge practices in a hospital medicine division, motivated by the fact that 40–50% of hospitalized patients with diabetes require insulin at discharge and that insulin is a high-risk medication prone to dosing and prescribing errors during transitions of care. The authors noted that discharge practices were inconsistent and often lacked clear diabetes-specific instructions.<br /><br />To better understand current practice, the team collected internal quality data on patients discharged on insulin, including length of stay and readmission rates, and created a Qualtrics survey distributed by email and promoted during noon conference. The survey assessed use of diabetes-related order sets, consult patterns for diabetes educators, discharge instructions, patient education, and outpatient medication regimens.<br /><br />The survey had a 28% response rate, with 43 of 156 faculty responding. More than half of respondents had been in hospital medicine for 1–4 years. Respondents rated order set use on a Likert scale from “never” to “always.” The most common reasons for consulting a diabetes educator were frequent admissions, poor understanding of diabetes, or a new diagnosis. Key barriers to discharge included insulin cost, lack of outpatient follow-up, and insufficient patient education.<br /><br />The authors concluded that improving use of order sets and standardized “dot” phrases, increasing appropriate diabetes educator consultations, and strengthening both patient and provider education are the initial priorities for standardizing diabetes discharge care. Future work will focus on improving educator efficiency and evaluating whether these interventions improve length of stay, readmissions, and other diabetes-related outcomes.

Asset Subtitle

Radha Devi Radhakrishna Pillai

Meta Tag

Author List Alberto Sobrero, Han Li, Joyce Ji, Kim Crouse, Radha Devi Radhakrishna Pillai, Timothy Evans

Category Research

Concept Insulin

Concept Hospital Discharge

Concept Diabetes Mellitus

Concept Medication Error

Concept Discharge Planning

Distinguished Non-Finalist

Presenter Organization Washington University School of Medicine

Presenting Author Radha Devi Radhakrishna Pillai

Track Quality Improvement

Keywords

insulin discharge

diabetes management

hospital medicine

survey study

order sets

diabetes educator

patient education

transition of care

readmission rates

discharge practices

Insulin

Hospital Discharge

Diabetes Mellitus

Medication Error

Discharge Planning