Volume 216 - Issue 2
The Queensland Inpatient Diabetes Survey (QuIDS) 2019: the bedside audit of practice
Authors: Rahul D Barmanray, Mervyn Kyi and Spiros Fourlanos
Med J Aust 2022; 216 (2): 104-104. || doi: 10.5694/mja2.51382
Published online: 7 February 2022
Published online: 7 February 2022
To the Editor: We congratulate Donovan and colleagues1 on their snapshot bedside audit of 850 inpatients with diabetes across 27 Queensland hospitals. The results in their audit identified current strengths and deficits in inpatient diabetes management. These efforts will be invaluable to the planning of future improvement interventions in Australia.
Inpatient diabetes management centres on improving glycaemia, as measured by reducing incident hypo‐ and hyperglycaemia, in order to reduce the consequences of dysglycaemia. While auditing bedside practice is important, it describes only part of the picture of inpatient diabetes. The complementary counterpart that augments the value of such auditing is the process of glucometric assessment, which is being enabled by the introduction of point‐of‐care networked blood glucose monitoring in Australian hospitals, with the first hospital‐wide system instituted in 2019.2
Glucometry involves collecting all blood glucose measures for inpatients throughout an admission and calculating mean and threshold indices of glucose management, which assists bedside care as well as enabling virtual glycaemic care programs.3 The potential synergy between glucometric assessment and bedside practice audits arises when these audits identify a change in practice within a hospital. Any resulting changes in that institution’s glucometric trends will provide quantitative information about the value of that practice change. This will enable the widespread dissemination and adoption of those practices found to have the greatest beneficial effects on glycaemia, and will provide an evidence base for generating national standards.4,5
Similarly, after adjusting for differences and variability in patient populations, glucometric benchmarking enables comparisons to be made between hospitals.6 When cross‐referenced with differences in practice, as identified by audits such as the Queensland Inpatient Diabetes Survey (QuIDS),1 the effects of these differences may be determined and their independent value thus broadly quantified.
We applaud the increasing national adoption of both electronic medical records and networked blood glucose monitoring, enabling future glucometric benchmarking.7 In the face of the ever‐increasing prevalence of diabetes in hospitals,8 it is crucial for all those involved in inpatient diabetes care to champion the twin quality procedures of auditing bedside practice and glucometric benchmarking. It is only together that these processes can best help us achieve optimal outcomes in hospital for people with diabetes.
Competing interests
No relevant disclosures.
References
- Donovan P, Eccles‐Smith J, Hinton N, et al. The Queensland Inpatient Diabetes Survey (QuIDS) 2019: the bedside audit of practice. Med J Aus 2021; 215: 119–124. https://www.mja.com.au/journal/2021/215/3/queensland‐inpatient‐diabetes‐survey‐quids‐2019‐bedside‐audit‐practice
- Barmanray RD, Rowan LM, Tsan J, et al. Nursing perceptions of the importance of blood glucose monitoring in hospital wards. Br J Health Care Manag 2020; 26: 162–167.
- Rushakoff RJ, Sullivan MM, MacMaster HW, et al. Association between a virtual glucose management service and glycemic control in hospitalized adult patients: an observational study. Ann Intern Med 2017; 166: 621–627.
- Department of Health, Australian Government. Australian National Diabetes Strategy 2016–2020. https://www.health.gov.au/resources/publications/australian‐national‐diabetes‐strategy‐2016‐2020 (viewed Dec 2021).
- Andrikopoulos S, James S, Wischer N. What gets measured gets improved — setting standards and accreditation for quality improvement for diabetes services in Australia. J Diabetes Sci Technol 2021; 15: 748–754.
- Kyi M, Colman PG, Rowan LM, et al. Glucometric benchmarking in an Australian hospital enabled by networked glucose meter technology. Med J Aust 2019; 211: 175–180. https://www.mja.com.au/journal/2019/211/4/glucometric‐benchmarking‐australian‐hospital‐enabled‐networked‐glucose‐meter
- Northern Health. Smart glucometers benefiting Northern Health patients [media release]. 16 November 2020. https://www.nh.org.au/smart‐glucometers‐benefiting‐northern‐health‐patients/ (viewed Dec 2021).
- Australian Institute of Health and Welfare. Diabetes [Cat. No. CVD 82]. https://www.aihw.gov.au/reports/diabetes/diabetes/contents/hospital‐care‐for‐diabetes (viewed Dec 2021).
Linked content
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MJA Research: The Queensland Inpatient Diabetes Survey (QuIDS) 2019: the bedside audit of practice
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MJA Letter: In reply