Objectives: To assess the quality of care for patients with diabetes in Queensland hospitals, including blood glucose control, rates of hospital-acquired harm, the incidence of insulin prescription and management errors, and appropriate foot and peri-operative care.Design, setting: Cross-sectional audit of 27 public hospitals in Queensland: four of five tertiary/quaternary referral centres, four of seven large regional or outer metropolitan hospitals, seven of 13 smaller outer metropolitan or small regional hospitals, and 12 of 88 hospitals in rural or remote locations.Participants: 850 adult inpatients with diabetes mellitus in medical, surgical, mental health, high dependency, or intensive care wards.

Background Diabetes is common in hospitalised patients and despite this inpatient diabetes care in Queensland has not had large scale benchmarking or audit. Aims To establish the prevalence of diabetes in Queensland hospitals and assess the availability of specialised diabetes staff, educational resources and policies for inpatient diabetes management, including assessing equity of access to these resources. Methods The hospital capacity, prevalence of diabetes, diabetes‐related resources and the availability of diabetes‐related guidelines were assessed in 25 hospitals medical, surgical, mental health, high‐dependency and intensive care wards across Queensland. Dedicated diabetes staffing measured in full‐time equivalents (FTE), care delivery resources, access to educational resources, standard policies and procedures for care were assessed. Results Twenty‐five hospitals included 4265 occupied beds. The median prevalence of diabetes was 22.9% (interquartile range (IQR) 17.3–28.5%) with an average 2.9 FTE per 100 patients with diabetes (IQR 0–6.3). There was difficulty in accessing a diabetes educator in 48% (n = 12), diabetes specialist in 44% (n = 11), orthopaedic surgeon in 48% (n = 12), podiatrist in 58% (n = 14) and vascular surgeon in 64% (n = 16) of hospitals. Small hospitals had more difficulty accessing all members of the diabetes team compared with large hospitals including credentialled diabetes educators 33% (n = 4) versus 62% (n = 8) (P < 0.01), diabetes specialists 17% (n = 2) versus 69% (n = 9) (P < 0.01) and vascular surgeons 33% (n = 4) versus 92% (n = 12) (P < 0.01). Diabetes‐related staff education and regular nurse training was available in 40% (n = 10) of hospitals. A multi‐disciplinary foot care team was available in 28% (n = 7) of hospitals. Conclusions Queensland has a high prevalence of diabetes in hospitalised patients and they have limited and inequitable access to inpatient diabetes‐related care.

Most hospitals have implemented Think Glucose but, despite this, the National Inpatient Diabetes Audit continues to demonstrate that further improvement in inpatient diabetes care is required. We show how process changes through the use of IT systems and audit can improve outcomes beyond health care professional education alone. Copyright © 2014 John Wiley & Sons.