Inside out paediatric diabetes – a 360 degree approach

Summary

The team developed a culture of equality and reciprocity with its users (co-production) and a series of co-design sessions provided patients with the opportunity to construct a vision of their ideal service.  Recurring themes included a venue that is more conducive to learning; hands-on support when carrying out calculations of carbohydrate content during actual food preparation and service; the involvement of other family members and several other agencies involved in the child’s care; and a greater time allocation for appointments. Through the training of schoolteachers, teaching assistants, catering staff – as well as parents and siblings, or foster carers, social workers and young person practitioners – a solid foundation is laid down for the seamless management of this chronic, lifelong condition.

Challenge

In June 2012 the team decided to change the way in which paediatric diabetes care was delivered to patients and their families. Since 2004 it has operated in the community with home visits alongside clinic visits every three months, but there were a high percentage of patients with a high HbA1c and a lot of DNAs to the paediatric diabetes clinics with only 9 patients (11.8%) out of 76 countable patients achieving a HbA1c of <58 Mmol/mol and 35 patients out of the 76 (46%) with a HbA1c of >75 Mmol/mol. The overall average HbA1c of all our patients was 76Mmol/mol.

Objectives

To provide the patient with a unique gold standard service that was built around them and their needs outside the hospital; to improve their experience and their engagement; to increase the time we were able to provide to them and place that suited them; to improve patient HbA1c levels and therefore improve their overall long term health; and to reduce DNAs. 

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QiC Diabetes Finalist 2015
Best initiative for children, young people and emerging adults
Inside out paediatric diabetes – a 360 degree approach
by Imperial College Healthcare NHS Trust



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