Data collection for study: Open Publication date: Winter 2018 (tbc)
The aim of this study is to identify and explore remediable factors in the process of care in the peri-operative management of surgical patients with diabetes across the whole patient pathway from referral for surgery (elective) or admission to hospital (emergency) to discharge from hospital.
To examine organisational structures, processes, protocols and care pathways in hospitals from pre-admission through to discharge or death
To identify avoidable and remediable factors in the management of patients:
admitted (as an elective or emergency admission) with a diagnosis of diabetes mellitus
who have had a major operation (minor procedures to be excluded - OPCS codes listed below)
and who have had a planned overnight stay of at least one night post surgery, focusing on the following areas of care:
Timing, assessment (including pre-assessment and optimisation for elective patients) and urgency of admission/referral
Appropriate documentation, record sharing and management of diabetes mellitus
Multi-disciplinary review and follow-up throughout admission
Escalation of care decisions and planning including step down from critical care and enhanced recovery after surgery
Management of nutrition, fluids, critical incidents and medications
Management of delays in the process, and risk assessment
Appropriate discharge planning, communication to primary care including relevant information in the discharge letter, and planned follow-up
Organisational aspects of the pathways of care of elective and emergency patients with diabetes including aspects of staff training, patient education, administration of medicine and the management of day surgery.
All adult patients (aged 16 and older) that were admitted (either as an emergency or elective admission) who have a diabetes mellitus diagnosis (ICD10 code E10.0-E11.0) who have had a major operation with a length of stay of at least one night post surgery between the time frame 1st February 2017 – 31st March 2017.
Day cases without an overnight stay
Patients who underwent a minor procedure (please see Appendix A in the downloads section for full list of exclusion codes)
Patient identifier spreadsheets will be disseminated in May 2017. The spreadsheet can be downloaded from the Download Links section on the left.
Clinical questionnaire and case notes
To be disseminated in October/November 2017.
This questionnaire will collect data on organisational aspects of care at your site that relate to this study. We ask that the Local Reporter liaise with the relevant person(s) that can accurately complete the questionnaire. This questionnaire will be disseminated in December 2017.
We are also collecting additional data on the numbers of procedures undertaken in patients with diabetes and those performed in day surgery via an Excel Spreadsheet; both the Excel Spreadsheet and the organisational questionnaire can be downloaded from the Download Links section on the right.
Recruitment of Case note Reviewers for this study is now closed.
This webpage is updated regularly, so please check back for more information shortly.