Diabetes Education Referral from the Emergency Department to Improve Patient Care and Health Literacy

Diabetes is a complex disease that can lead to increased morbidity and mortality. Inadequate disease management is considered when patients present to the emergency department (ED) for care related to this disease. Once out of the hospital or ED, it is imperative the patient receives timely follow-up care to effectively manage the disease to reduce morbidity and mortality and to decrease return visits to the ED. Primary care across the nation is facing a national shortage with provider time spent with patients decreasing and patients’ length of time spent waiting to get an appointment increasing (Medscape, 2017; Merritt Hawkins, 2017 ). Diabetes Education Centers are available in various settings throughout the Denver Metropolitan area. Diabetes education could provide acute self-management skills, lifestyle, and behavior modifications. Diabetes education is an intervention supported by the American Diabetes Association (2018) and paid for by most insurances including Medicaid and Medicare. Adding this modality to treatment helps diversify and intensify the patient’s own health literacy and ability in managing his/her diabetes disease. The Medical Center of Aurora (TMCA) is a Level II Trauma Center in a large suburb of Denver, Colorado. Discharge practice includes referring diabetic patients to follow up within days at their primary care provider; this time frame could be iv problematic for patients. This project evaluated current ED provider knowledge of outpatient follow-up care and outpatient diabetes services available to discharged ED patients. The Doctor of Nursing Practice student then provided an educational intervention to address identified gaps in knowledge and evidence regarding TMCA’s Diabetes Education Center as an adjunct in follow up the provider could then include in the discharge instructions. A post-intervention survey gauged providers’ new knowledge and probability of providing this referral to their ED patients in the future. Lastly, an initial implementation of making a referral to an outpatient diabetes center was observed and evaluation performed