Catherine Leon, Clare Crowley, Helen Hogan, Yogini H. Jani
{"title":"A new approach to identifying safety measures across transfers of care for people who use insulin for Type 2 diabetes","authors":"Catherine Leon, Clare Crowley, Helen Hogan, Yogini H. Jani","doi":"10.1111/dme.70101","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>When people who use insulin for Type 2 diabetes have a hospital admission and discharge, they are at risk of harm from incorrect, delayed, or missed insulin doses. Leading indicators can highlight potential areas of risk, providing opportunities to improve safety. Modelling the complex transfer of care pathway can provide insight into where leading indicators could be targeted to support improved outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Multiple qualitative methods were used, and a framework approach was applied to identify activities (termed functions) involved in managing insulin during the transfer of care, and how factors involving people, equipment and environments (local, organisational and external) impacted these. The Functional Resilience Analysis Method was used to map the transfer of care pathway, and key areas of variability were identified. These areas of variability and two example functions were validated and discussed with key/representative stakeholders in an online seminar.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 59 functions were mapped, and 21 were identified as key functions for potential new measures. These 21 functions were validated at a seminar, and two example functions, empowering people with diabetes who use insulin to manage their diabetes and arranging self-administration of insulin in hospital, were discussed in detail. A selection of potential measures was identified.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Many potential areas for new leading indicators were identified, and examples of potential measures were described. A coproduction approach is required to expand, define and validate these. Such measures provide an opportunity for proactively improving insulin safety during care transfers.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 10","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70101","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dme.70101","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aims
When people who use insulin for Type 2 diabetes have a hospital admission and discharge, they are at risk of harm from incorrect, delayed, or missed insulin doses. Leading indicators can highlight potential areas of risk, providing opportunities to improve safety. Modelling the complex transfer of care pathway can provide insight into where leading indicators could be targeted to support improved outcomes.
Methods
Multiple qualitative methods were used, and a framework approach was applied to identify activities (termed functions) involved in managing insulin during the transfer of care, and how factors involving people, equipment and environments (local, organisational and external) impacted these. The Functional Resilience Analysis Method was used to map the transfer of care pathway, and key areas of variability were identified. These areas of variability and two example functions were validated and discussed with key/representative stakeholders in an online seminar.
Results
A total of 59 functions were mapped, and 21 were identified as key functions for potential new measures. These 21 functions were validated at a seminar, and two example functions, empowering people with diabetes who use insulin to manage their diabetes and arranging self-administration of insulin in hospital, were discussed in detail. A selection of potential measures was identified.
Conclusions
Many potential areas for new leading indicators were identified, and examples of potential measures were described. A coproduction approach is required to expand, define and validate these. Such measures provide an opportunity for proactively improving insulin safety during care transfers.
期刊介绍:
Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions.
The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed.
We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services.
Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”