Background: Dietetic input in diabetes care has been shown to reduce hospitalisations and associated costs (1, 2). Nevertheless, staffing levels may prevent hospital Dietitians from attending to all diabetes referrals. In our case, a system was required to ensure that higher risk inpatient referrals were identified and attended.
Aim: To evaluate whether a triage tool would ensure all inpatients referred for diabetes care are given access to dietetic services consistent with level of acute risk.
Service evaluation: Inpatient diabetes referrals (Dietitian plus Diabetes Educator referrals) were audited for two months pre and post implementation of a risk assessment triage tool. The tool has not been validated, however risk criteria were extrapolated from literature and expert consensus of senior Diabetes Dietitians across multiple hospitals. Risk factors were assigned scores, which when totalled, fell into four priority categories. Priority 1 patients were to be seen before discharge. Priority 2 and 3 were offered outpatient appointments within 2 weeks or 3 months respectively. Priority 4 were sent diabetes information and a list of non-hospital dietetic options. All score combinations were checked using clinical judgement for appropriate prioritisation. Senior diabetes Dietitians performed the triaging; in liaison with inpatient Dietitians, Diabetes Educators and outpatient services. A database captured every triage decision and service outcome.
Results: Prior to the triage tool, 69% of referred inpatients in the three highest risk categories received access to dietetic services consistent with their level of risk (see Table 1). Following implementation, this increased to 93%, (an improvement of 24%).The remaining 7% of cases not meeting targets were explained by circumstances beyond our control.
Conclusion: The use of a triage tool is an effective means of ensuring that inpatients referred for diabetes care are given access to dietetic services consistent with level of acute risk.