The Rowan Hillson Inpatient Safety Award 2022
The best interventions: redesigning, rebuilding and maintaining safe inpatient diabetes care during COVID
Keywords:inpatients, safety, award, diabetes, COVID
Introduction: The annual National Diabetes Inpatient Audit (NaDIA and NaDIA-Harms) in the UK continues to show signiﬁcant problems with patient care. During the COVID pandemic patient care has been even more difﬁcult. New initiatives are urgently required to improve inpatient safety for people with diabetes.
Method: The Joint British Diabetes Societies for Inpatient Care (JBDS-IP) organised the seventh national Rowan Hillson Inpatient Safety Award on the theme of “the best interventions: redesigning, rebuilding and maintaining safe inpatient diabetes care during COVID”.
Result: The winner was the DEKODE team, led by Dr Punith Kempegowda from University Hospitals Birmingham NHS Foundation Trust, for their innovative quality improvement project across hospitals during COVID to improve diabetes-related ketoacidosis (DKA) management and study DKA in people with COVID. Adherence to national guidance improved in some hospitals, with falls in hypoglycaemia, and overall there was a signiﬁcant improvement in awareness about DKA amongst junior doctors.
The King’s College NHS Foundation Trust team, led by Adrian Li and colleagues, received the highly commended award for their innovative project of remote blood glucose (BG) monitoring across healthcare boundaries. This improved diabetes control and tackled health inequalities.
Summary and conclusion: These and similar schemes need to be developed, promoted and shared to improve safety for people with diabetes admitted in hospital during COVID times.
NHS Digital. National Diabetes Inpatient Audit 2019. https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-inpatient-audit/2019 (accessed 13 January 2021)
NHS Digital. National Diabetes Inpatient Audit - Harms 2020 England - NHS Digital (accessed 27 May 2022)
Dashora U, Sampson MJ, Castro E, et al. Rowan Hillson Insulin Safety Award ‘best in class’ insulin prescription chart competition. Br J Diabetes Vasc Dis 2015;15:135-8. https://doi.org/10.15277/bjdvd.2015.028
Dashora U, Sampson MJ, Castro E, et al. The best hypoglycaemia avoidance initiative in the UK. Br J Diabetes 2017;17:74-7. https://doi.org/10.15277/bjd.2917.126
Dashora U, Sampson M, Castro E, et al. The best joint pharmacy and diabetes team initiative to improve insulin and prescribing safety in hospital. Br J Diabetes 2018;18:163-6. https://doi.org/10.15277/bjd.2018.195
Dashora U, Sampson M, Castro E, et al. The Rowan Hillson Inpatient Diabetes Safety Award 2017 for the best digital initiative. Br J Diabetes 2018;18:110-12. https://doi.org/10.15277/bjd.2018.182
Dashora U, Sampson M, Castro E, et al. The Rowan Hillson Inpatient Safety Award 2018 for the best inpatient diabetes educational programme for healthcare professionals. Br J Diabetes 2020;20:151-4. https://doi.org/10.15277/bjd.2020.264
Dashora U, Laurent DB, Leech N, et al. The Rowan Hillson Inpatient Safety Award 2019 for the best perioperative pathway for people with diabetes. Br J Diabetes 2021;21:149-53. https://doi.org/10.15277/bjd.2021.296
Gibb FW, Teoh WL, Graham J, Lockman K. Risk of death following admission to a UK hospital with diabetic ketoacidosis. Diabetologia 2016; 59:2082-7. https://doi.org/10.1007/S00125-016-3034-0
Wright J, Ruck K, Rabbitts R, et al. Diabetic ketoacidosis (DKA) in Birmingham, UK, 2000—2009: an evaluation of risk factors for recurrence and mortality. Br J Diabetes Vascular Dis 2009;9:278-82. https://doi.org/10.1177/1474651409353248
Kempegowda P, Chandan JS, Coombs B, et al. Regular Performance Feedback May Be Key to Maintain Good Quality DKA Management: Results from a Five-Year Study. BMJ Open Diabetes Research Care 2019;7: e000695. https://doi.org/10.1136/bmjdrc-2019-000695
Kempegowda P, Coombs B, Nightingale P, et al. Regular and Frequent Feedback of Speciﬁc Clinical Criteria Delivers a Sustained Improvement in the Management of Diabetic Ketoacidosis. Clinical Medicine 2017;17: 389–94. https://doi.org/10.7861/clinmedicine.17-5-89
Kempegowda P, Melson E, Johnson A, et al. Effect of Covid-19 on the Clinical Course of Diabetic Ketoacidosis (Dka) in People with Type 1 and Type 2 Diabetes. Endocrine Connections 2021;10:371–77. https://doi.org/10.1530/EC-20-0567
Ooi E, Nash K, Rengarajan L, et al. Clinical and Biochemical Proﬁle of 786 Sequential Episodes of Diabetic Ketoacidosis in Adults with Type 1 and Type 2 Diabetes Mellitus. BMJ Open Diabetes Research Care 2021;9: e002451. https://doi.org/10.1136/bmjdrc-2021-002451
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