Young people with diabetes (YP) are prone to disengaging from diabetes specialist services (DSS) during the transition from paediatric to adult care. Strategies to keep YP engaged with DSS are important to improve transition outcomes (1). Our transition service (TS) provides a multidisciplinary ‘one stop shop’ to facilitate transition for YP.
We aimed to ensure YP registered with our TS remain engaged with DSS during their transition from paediatric to adult health services.
Three key performance indicators (KPIs) & strategies were implemented in 2013 & monitored quarterly for 12 months. KPIs included YP who failed to attend (FTA) an appointment, YP overdue if they had not attended clinic in ≥ 4 months & did not have a future appointment, or YP who did not follow up after a diabetes related emergency department (ED) presentation. Strategies included appointment cards & letters, SMS reminder & phone call on day of appointment, phone call & letter for FTA & overdue YP &/or their GP, & referral of vulnerable YP to our social worker. Data were retrospectively collated & analysed using reports from patient management & ED information systems & a paediatric diabetes database.
Mean age of YP identified through KPIs was 19 years (range 15-24) over the 12 month period. There were 70 occasions where YP FTA (mean FTA rate 18%, range 9-24%); 52 YP were found to be overdue (mean 13, range 8-17) & of 23 ED presentations failure to follow up was 4% (range 0-18%).
In conclusion, TS registered YP at risk of disengaging from DSS were identified through our KPIs, despite our use of strategies to maximise engagement during transition. Limitations of this quality study include the reasons for failure to engage are not known & numbers are small. Further research is needed to develop strategies to reduce the risk of DSS disengagement.