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Developing a Young Adult Diabetes Service

The Tweed Hospital
Project Added:
2 June 2015
Last updated:
16 June 2015

Developing a Young Adult Diabetes Service

Summary

This project developed a specialist diabetes service for people aged 16 to 25, at The Tweed Hospital in Northern NSW Local Health District (NNSWLHD). 

Aim

To address the gap between paediatric and adult diabetes services, using a multidisciplinary approach to improve health literacy and outcomes of people aged 16 to 25.

Benefits

  • Reduces drop-out rates in people aged 16 to 25 attending a diabetes clinic.
  • Provides quarterly access to an endocrinologist, diabetes educator and dietician.
  • Improves access to regular HbA1c blood tests.
  • Improves referral pathway to diabetes clinics by general practitioners.
  • Improves access to ‘at risk’ patients who have been admitted to hospital for diabetes-related issues.

Project Status

Project status

Implemented - The initiative is ready for implementation or is currently being implemented, piloted or tested.

Project dates

  • Start: September 2014
  • Finish: September 2015

Background

In 2009, diabetes paediatric clinics were established at The Tweed Hospital to provide children and their families with access to a paediatrician, diabetes educator and dietician. Since that time demand has grown, to the point where some paediatricians have had to split their clinic in two due to large numbers. Clinicians also reported high drop-out rates of people aged 16-25 years, due to cost, access, appointment schedules and perceived lack of support. It was determined that a stepping stone between paediatric and adult diabetes services was required, to address the increasing demand  and reduce drop-out rates for people aged 16 to 25.

Implementation

  • Following a review, a Young Adult Diabetes Service (YADS) was created as a stand-alone clinic specifically for young people aged 16-25 years.
  • An adult endocrinologist runs these clinics within a multidisciplinary team, with a diabetes educator to assist with familiarity and continuity.
  • Participants are sourced from paediatric diabetes clinics, as well as past patients of The Tweed Hospital. Clients admitted to hospital with diabetes-related issues are also invited to attend.
  • The YADS clinic is run on a monthly basis from 12pm to 4pm, with SMS reminders for invited participants.
  • Following an initial consultation with a diabetes educator, each participant meets with an endocrinologist and dietician on a quarterly basis.
  • Individual follow-up appointments are scheduled with clinicians such as psychologists on a more regular basis if required or requested.
  • Approved screening tools are used to determine any distress or depression in participants.
  • An information sheet has been drafted, to increase awareness of health-related topics such as drugs, alcohol, Centrelink and tattoos.
  • Consistent staffing helps participants establish trusted relationships with clinicians.

Partnership

  • Tweed Community Health 

Evaluation

The following measures are in place to evaluate the success of the program after 12 months:

  • collection of baseline data, including HbA1c levels, weight and body mass index
  • surveys to determine participant knowledge and satisfaction with YADS
  • measurement of attendance, referral rates and demographics
  • review of services provided and timing of these services, based on levels of participation and feedback
  • assessment of drop-in rates of 16 to 25 years olds admitted with diabetic ketoacidosis (DKA) in the hospital, compared to 2013 rates prior to the development of YADS.

Lessons Learnt 

  • Returning participants provide positive reinforcement for staff and demonstrate the value of the service.
  • Introduction to appropriate supportive social media for peer support.
  • Move from mentality of client turnover to patient-centred care.
  • Need for consistent nursing support to attend to baseline health data collection.
  • Refining process for referrals to mental health services.
  • Clinic times may need to be changed for improved access after work hours.

Further Reading

Contact

Shelley Jedrisko
Diabetes Clinical Nurse Coordinator
The Tweed Hospital
Northern NSW Local Health District
Phone: 07 5506 7803
Email: Shelley.Jedrisko@ncahs.health.nsw.gov.au

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