Healthcare Provision for Diabetes in Canada and Globally: Perspectives of Multiple Stakeholders in the Second Diabetes Attitudes, Wishes and Needs (DAWN2) Study

Abstract

audio recorded, transcribed and analyzed for themes using categorization and line-by-line coding. Results: Four main themes emerged: (1) the importance of personalized medicine in transition health given the individuality of each patient experience; (2) communication barriers between the patient and healthcare team, notably regarding the execution of the transition itself and location of future health services; (3) the significance of ensuring adolescent to new adult physician compatibility prior to transition and (4) the poor management of adolescents in pediatric medicine, particularly with respect to identifying their maturity level and subsequently offering appropriate healthcare. Conclusions: We have identified tangible areas of the transition process in the TEGH community that require improvementdall of which converge on an over-arching theme of communication between the patient and their new and old healthcare providers. 48Using Prospective Analysis to Improve Quality Care in the Surgical Patient with Diabetes NORA B. DIXON * , JENNIFER A. ISTVAN * Scarborough, ON An insulin-using patient with diabetes who required surgery was identified by those caring for the individual to be at high risk of receiving fragmented care due to the focus of the admission being surgical. A formal review of our current process was undertaken using the Failure Modes and Effects Analysis (FMEA) methodology. Through this systematic review, potential failure modes and their potential effects were identified. These were ranked according to severity, frequency and detectability. Four major potential failures were identified: 1) pre-operative instructions were being given to the patient verbally, with no copy available for reference on the day of surgery; 2) the transfer of information from the OR to the internist providing post-operative care was lacking; 3) transfer of information from the pre-operative assessment to the post-operative internist providing care was lacking; 4) staffing of pharmacists at preadmission clinics was inconsistent. The impact of these potential failures was that this group of patients arrived at the post-operative unit with poor management of their diabetes care resulting in patients requiring treatment for preventable problems, such as hypoglycemia. The outcomes of the FMEA process were: 1) implementation of a double copied medication instruction sheet completed during the pre-admission clinic visit with a copy provided to the patient and a copy placed on the chart; 2) a pre-printed order set, to be completed at the pre-admission visit, with orders for post-operative diabetes care to be implemented at the authorization of the anaesthetist and 3) review of pharmacy staffing in the preadmission clinic. Purpose: Canada, 1 of 17 countries participating in the DAWN2 study, identified areas to improve for diabetes self-management among people with diabetes (PWD), family members (FMs) and healthcare professionals (HCPs).Methods: Five hundred PWDs, 121 FMs and 281 HCPs were surveyed using validated, adapted and ...